WHO warns of the misuse of antibiotics in human medicine and agriculture

Antibiotics save lives. Used to treat and control infections, antibiotics are critical for the prevention and treatment of communicable diseases, neonatal care, transplantation, chemotherapy for malignancy, immunosuppression, safe surgery, safe obstetric care and intensive care interventions

However, a recent article in New York Times commented that “Researchers and experts have also warned for years that antibiotics, miracle drugs that have changed the course of human health in the 20th century, are losing their power because of overuse, misuse or underuse”.

Antibiotic resistance – when antibiotics no longer work in people who need them to treat bacterial infections – is now one of the world's most pressing public health problems. Almost every type of bacteria has become resistant to at least one antibiotic, resulting in the antibiotic being less effective for treatment when it is really needed.

If standard treatments becomes ineffective, infections could persist and spread, and this could threaten communities with new strains of infectious disease, that are more difficult to cure and more expensive to treat.

This can cause significant danger and suffering for children and adults who have common infections, once easily treatable with antibiotics. If one person has an infection that is resistant to a certain medicine, he or she could pass on that resistant infection to another person. In this way, a hard-to-treat illness can spread from person to person. In some cases, the illness can lead to serious disability or even death.

Many researchers and experts have warned that the world is headed for a post-antibiotic era, in which common infections and minor injuries that have been treatable for decades can kill once again.

While antibiotic resistance refers specifically to common bacteria that cause infections, antimicrobial resistance or drug resistance refers to the ability of all types of microbes including bacteria (e.g. E. coli, N. gonorrhoeae), viruses (e.g. HIV) and parasites (e.g. malaria parasites) to stop an antibiotic, antiviral or antimalarial from working against it, thereby reducing the effectiveness of the drug to cure and prevent an infection.

Microbes can develop resistance to specific medicines. Once a microbe is resistant to many drugs, treating the infections it causes can become difficult or even impossible. A common misconception is that a person's body becomes resistant to specific drugs. However, it is microbes, not people, who become resistant to the drugs.

In the Western Pacific Region, antimicrobial resistance against common bacteria like E. coli, M. tuberculosis and S. pneumonia, as well as influenza, HIV and malaria is happening in communities and hospitals. Ensuring that patients with bacterial infections are informed about the need to take a full course of antibiotics within a specified time frame requires action from policy-makers, medical professionals, pharmacists, pharmaceutical industry, patients and the general public.

In 2014, WHO’s governing body, the World Health Organization passed a resolution (WHA67.25) to combat antimicrobial resistance, focusing on antibiotic resistance. That same year, WHO published “Antimicrobial resistance: a global report on surveillance”, which painted the most comprehensive picture of antimicrobial resistance to date. With data provided by 114 countries, this report shows alarming levels of antibiotic resistance in all parts of the world.

In some countries in the Western Pacific Region, weak drug quality assurance systems are allowing the proliferation of poor quality medicines, exposing patients to suboptimal concentrations of antimicrobials, and creating optimal conditions for drug resistance to develop. In some countries, poor access to antimicrobials forces patients to take incomplete courses of treatment or to seek alternatives that could include substandard medicines.

Weak surveillance systems with limited capacity to collect and report relevant data on drug resistance on a regular basis are also contributing to drug resistance. Some countries also lack laboratory facilities that can accurately identify resistant microorganisms. This impairs the ability to detect emergence of resistant microorganisms and to take prompt actions.

Besides the use of antibiotics for treatment of infection in humans, antibiotics are also commonly used in industrial farming, making animal husbandry another source of drug resistance. Sub-therapeutic doses of antibiotics are used in animal husbandry for promoting growth or preventing diseases. This can result in resistant microorganisms, which can spread to humans.

In the United States of America, to illustrate the scale of the use of antibiotics, more than 70% of antibiotics are given to animals. Experts have yet to agree on how much of that use of antibiotics in industrial-scale farming actually contributes to problems in humans.

Animal rearers use antibiotics to prevent sickness when animals are packed together in ways that breed infection. They use them to make animals grow faster, though many policy-makers have in recent years taken measures to curb their use.

The use of antibiotics both in medical and agricultural fields need to be regulated. There is a need to raise awareness among consumers to demand more control over the use of antibiotics for commercial rearing of poultry and other livestock.

For more information please contact:
Tan Irene, Communications Officer
WHO Country Office, Lao People’s Democratic Republic
Tel: +856 21 353902
Email: tani@wpro.who.int