Antibiotic resistance occurs when bacteria develops mechanisms to reduce the effects of the antibiotic. These mechanisms evolve through mutation and adaptation. Mutations can be good or bad for bacteria. In some cases, the mutation kills the bacteria and it may provide the bacteria with a survival advantage. The survival advantage may include resistance to antibiotics. In the presence of antibiotics, this resistance becomes an advantage and the resistant strain becomes dominant.
Bacterial resistance to antibiotics is a One Health concern. If this important class of drugs becomes ineffective, it will have a serious impact on the health of both humans and animals.
After Alexander Fleming discovered penicillin in 1928, work was undertaken with his colleagues Florey and Chain to make the molecule useable as a drug to treat infections in people. Fleming himself noted in his early observations that bacteria could become resistant to penicillin, even if used appropriately.
Understandably, given its significant impact on healthcare, penicillin was initially prescribed widely, but it became less effective over time.
- Bacterial multiplication, mutation and evolution (natural processes)
- Use of antibiotics for non-infection control reasons
- Prescribing antibiotics 'just in case' for illnesses may speed the development of resistance
- A significant reduction in the availability of novel antibiotic classes.
What does this mean?
Research for new antibiotics is an area of focus that has Government support. However, the development and approval process for any new drug takes time. While this research is ongoing, we need to take measures to slow down the evolution of resistance and protect the drugs' efficacy.
This means that, as some antibiotics are no longer as effective as they used to be, healthcare and veterinary professionals have had to adapt their approach to administering antibiotics to help preserve the efficacy of those that currently still work. This work has resulted in significant drops in antibiotics used. The Veterinary Medicines Directorate reported a reduction in antibiotics in food-producing animals in the UK of 52% in six years (between 2014 and 2020).
Why is it important for veterinary medicine?
As antibacterial resistance is a growing concern in both human and animal medicine, there is pressure to preserve the medical use of certain antibiotics. This has implications for animal health and welfare. Veterinary professionals, therefore need to use antimicrobials responsibly. Using antibiotics only when appropriate also reduces the chances of drug side effects and reduces the carbon footprint of treating diseases.
In both human hospitals and veterinary practices, it is common to find recommendations for infections or conditions where antibiotics are not required. This is called Antibiotic Stewardship.
Prescribe only when necessary
Reduce prophylaxis
Offer other options
Treat effectively
Employ narrow spectrum
Culture appropriately
Tailor your practice policy
Monitor
Educate others