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Warning over “global pandemic of antibiotic resistance”

The threat of increased antibiotic resistance could return us to the"pre-antibiotic era", threatening vital components of modern medicine,Swedish medical experts have warned.

Major surgery, organtransplantation, and cancer chemotherapy will be threatened ifantibiotic resistance is not tackled urgently, Professor Otto Cars, ofthe Department of Medical Sciences, Uppsala University, writes in aneditorial on the BMJ website.

The professor warns that aconcerted global response is needed to address rising rates ofbacterial resistance caused by the use and abuse of antibiotics.

Allantibiotic use "uses up" some of the effectiveness of that antibiotic,diminishing the ability to use it in the future, say Professor Cars andhis colleagues, and antibiotics can no longer be considered as arenewable source.

They point out that existing antibiotics arelosing their effect at an alarming pace, while the development of newantibiotics is declining. More than a dozen new classes of antibioticswere developed between 1930 and 1970, but only two new classes havebeen developed since then.

According to the European Centre forDisease Prevention and Control, the most important disease threat inEurope is from micro-organisms that have become resistant toantibiotics.

In 2000, the World Health Organisation called for amassive effort to address the problem of antimicrobial resistance toprevent the "health catastrophe of tomorrow".

So why has so little been done to address the problem of resistance, ask the Swedish authors in the BMJ editorial?

Theysay antibiotics are overprescribed and are still illegally sold overthe counter in some EU countries, and self-medication with leftovermedicines is commonplace.

The authors claim that a dearth ofdata on the magnitude and burden of antibiotic resistance may explainwhy there has been little response to this public health threat frompoliticians, public health workers, and consumers.

The authorsbelieve that priority must be given to the most urgently neededantibiotics, and incentives given for developing antibacterials withnew mechanisms of action.

In addition, "the use of newantibiotics must be safeguarded by regulations and practices thatensure rational use, to avoid repeating the mistakes we have made byoverusing the old ones", they say.

They point out that reducingconsumer demand could be the strongest force to driving change —individuals must be educated to understand that their choice to use anantibiotic will affect the possibility of effectively treatingbacterial infections in other people.

But, they claim, theultimate responsibility for coordination and resources rests withnational governments, WHO and other international stakeholders.