Antibiotic Resistance: Opportunities and Challenges

Certain bacterial infections now defy all antibiotics. The resistance problem may be reversible, but only if society begins to consider how the drugs affect "good" bacteria as well as "bad". Historically, most antibacterials were used in hospitals, where they were incorporated into soaps and surgical clothes to limit the spread of infections. More recently, however, those substances (including triclocarbon, triclosan and such quaternary ammonium compounds as benzalkonium chloride) have been mixed into soaps, lotions and dishwashing detergents meant for general consumers. They have also been impregnated into such items as toys, high chairs, mattress pads and cutting boards.

Overall sales in the current antibiotics and new products market were nearly $40 billion in 2008. It increased to $41.5 billion in 2009. By 2015, it is projected to increase to $65.5 billion, for a 5-year compound annual growth rate (CAGR) of 9.6%. The largest segment antibiotic drugs market was nearly $36 billion in 2008; this further increased to $37 billion in 2009, this projected to reach $50 billion in 2015, for a 5-year CAGR of 5.9%. Sales in the bacterial vaccines market amounted to $3.6 billion in 2008 which increased slightly to $3.9 billion in 2009. This is projected to increase to $15 billion in 2015, for a 5-year CAGR of 31.6%.

The spread of antibiotic-resistant pathogens requires new treatments. As the rate of development of new antibiotics has severely declined, alternatives to antibiotics must be considered in both animal agriculture and human medicine. Products for disease prevention are different from those for disease treatment, and examples of both are discussed here. For example, modulating the gut microbial community, either through feed additives or fecal transplantation, could be a promising way to prevent certain diseases; for disease treatment, non-antibiotic approaches include phage therapy, phage lysins, bacteriocins, and predatory bacteria. Interestingly, several of these methods augment antibiotic efficacy by improving bacterial killing and decreasing antibiotic resistance selection. Because bacteria can ultimately evolve resistance to almost any therapeutic agent, it is important to continue to use both antibiotics and their alternatives judiciously.

  • Antibiotics and alternatives
  • Systemic intervention – values, conflict and blue room resolution
  • Grand challenges – antimicrobial resistance
  • Intervention against antimicrobial resistance – approaches and implementation

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