Antibiotic Resistance: Implications for Global Health and Novel Intervention Strategies

Review

Excerpt

Infectious diseases remain among the leading causes of morbidity and mortality on our planet. The development of resistance in microbes—bacterial, viral, or parasites—to therapeutics is neither surprising nor new. However, the scope and scale of this phenomenon is an ever-increasing multinational public health crisis as drug resistance accumulates and accelerates over space and time. Today some strains of bacteria and viruses are resistant to all but a single drug, and some may soon have no effective treatments left in the "medicine chest." The disease burden from multidrug-resistant strains of organisms causing AIDS, tuberculosis, gonorrhea, malaria, influenza, pneumonia, and diarrhea is being felt in both the developed and the developing worlds alike.

On April 6 and 7, 2010, the Institute of Medicine's (IOM's) Forum on Microbial Threats convened a public workshop in Washington, DC, to consider the nature and sources of antimicrobial resistance (AMR), its implications for global health, and strategies to mitigate the current and future impacts of AMR. Through invited presentations and discussions, participants explored the evolutionary, genetic, and ecological origins of AMR and its effects on human and animal health worldwide. Participants also discussed host and environmental factors associated with the expansion of AMR, strategies for extending the useful life of antimicrobials, alternative approaches for treating infections, incentives and disincentives for prudent antimicrobial use, and prospects for the discovery and development of "next generation" antimicrobial therapeutics. While it was the "intent" of the workshop planners and organizers to cover the phenomenon of AMR broadly, workshop presentations and discussions focused almost exclusively on bacterial resistance to antibacterial drugs.

Publication types

  • Review

Grants and funding

This project was supported by contracts between the National Academy of Sciences and the U.S. Department of Health and Human Services: National Institutes of Health, National Institute of Allergy and Infectious Diseases, Centers for Disease Control and Prevention, and Food and Drug Administration; U.S. Department of Defense, Department of the Army: Global Emerging Infections Surveillance and Response System, Medical Research and Materiel Command, and Defense Threat Reduction Agency; U.S. Department of Veterans Affairs; U.S. Department of Homeland Security; U.S. Agency for International Development; American Society for Microbiology; Sanofi Pasteur; Burroughs Wellcome Fund; Pfizer; GlaxoSmithKline; Infectious Diseases Society of America; and the Merck Company Foundation.