Have you ever met a human parasite

The antibiotic crisis

The scale of the problem is huge and frightening. The threat is real, it is ongoing, and the time to act is now.

Get an overview of the full extent of the antibiotic crisis: how resistance develops, how it spreads and what role we all play in it - and what that means in concrete terms, now and in the future. Hear and read what leading experts have to say and what alternatives and smart solutions researchers are currently working on to outsmart highly adaptable pathogens. Scientists, governments and global organizations collect data, try to formulate regulations and action plans and implement programs to contain antibiotic resistance and its consequences.

The fight has begun and its outcome is open. In order to prevent a relapse into the medical middle ages, in which any infection would mean a potential death sentence, each and every one of us must be aware of our responsibility - and face it.

It's time to wake up. Here is your wake up call!

What do you mean by "antibiotic resistance"? A seriously ill patient in a clinic who suffers from a germ against which every known antibiotic is powerless? This situation exists, of course, but it is only part of the problem. In fact, antibiotic resistance - or antimicrobial resistance, which also includes resistance caused by other microorganisms such as parasites, viruses or fungi - causes damage that goes far beyond the clinical realm. We are facing a truly global social problem that will sooner or later hit us all if we do not act together to stop it. So let's talk about it.

Antibiotics are drugs that are used to prevent and treat bacterial infections. (They DO NOT fight viruses and are therefore absolutely useless against viral infections like the common cold.) Antibiotics target, attack, and kill most of the bacteria involved.

However, some bacteria change and become resistant to these antibiotics. As a result, they survive the antibiotic attack and spread the very mutation that makes them immune. When the resistant bacteria then cause infections in humans and animals, these are much more difficult to treat than those caused by non-resistant bacteria.

In many cases, doctors no longer have any alternatives: in the European Union, for example, according to expert estimates, 33,000 people die every year from the direct consequences of an infection with antibiotic-resistant bacteria (https://ecdc.europa.eu/en/news-events/33000- people-die-every-year-due-infections-antibiotic-resistant-bacteria).

“This is a serious problem that is now with us, causing death. If it were anything else, people would be in a storm already. [...] We are really - if we don't act now - before a horrific post-antibiotic apocalypse. "

- Professor Dame Sally Davies, Chief Medical Advisor to the UK Government

“Put simply, if we don't address this problem now, we won't be able to treat common infections in the future. [...] Some types of bacteria that cause severe human infections have already developed resistance to most or all of the treatments available. "

- Dr. Marc Sprenger, Director of the WHO Secretariat for Antimicrobial Resistance

In the clinical environment, pathogens that develop antibiotic resistance are also referred to as “super germs”. (Probably because doctors have to use superpowers to get rid of them.) There are two main reasons given for antibiotic resistance: misuse (for example against viral infections in humans) and excessive use (for example in agriculture).

Bacteria can become resistant to antibiotics in several ways. Some bacteria can "neutralize" an antibiotic by modifying it so that it becomes harmless, and some have learned how to pump an antibiotic out of the pathogen before it can cause damage. Others can change their external structure so that the antibiotic has no way of even attaching to the bacterium, let alone killing it.

If even one bacterium becomes resistant to antibiotics, it can then multiply and replace any bacteria that were previously killed. The effect of antibiotics thus leads to what is known as “selection pressure”, through which the surviving bacteria are even more likely to become resistant. And the abusive and excessive use of antibiotics - if, for example, as mentioned above, they are prescribed for a cold caused by viruses - accelerates this process even further.

How is the problem spreading?

The spread of antibiotic resistance is almost a vicious circle in which humans and animals are involved. Bad hygiene and the abusive and excessive use of antibiotics all play a role.

The problem of antibiotic resistance has worried experts, sometimes more, sometimes less. However, the multitude of cases that researchers from around the world have compiled in the recent past are bitter to read and should provide the necessary impetus for major global changes.

That is the current state of affairs. In addition, researchers have calculated how antibiotic resistance and the resulting diseases and deaths will affect the global workforce. They found that the number of people of working age will decrease dramatically compared to a world without antibiotic resistance and that the loss of gross domestic product will be substantial.

"The scale and nature of this economic threat could destroy hard-won development gains and move us away from our goals of eradicating extreme poverty and enhancing common prosperity."

- Jim Yong Kim, Former President of the World Bank

So is doom inevitable? No, not in the least, because there are steps anyone can take to improve the situation.

Why is it so difficult to develop new drugs?

From the 1960s to the 1980s, pharmaceutical companies attempted to counteract the problem by developing many new antibiotics. In recent years, however, fewer and fewer antibiotics have been developed, so that the number of alternatives for treating germs that are constantly developing new resistances has steadily decreased. The pharmaceutical industry, which includes both companies and research institutes, is therefore called upon to resume its efforts to develop new antibiotics.

The good news is that some drug companies have already done just that. Researchers are also working more than ever to discover alternatives to antibiotics as well as enhancers to increase the effectiveness of antibiotics. In addition, governments around the world have joined the fight against global antibiotic resistance. You will learn more in the next chapter.

Medical solutions for antibiotic resistance

It should actually be very easy. If an antibiotic no longer works, shouldn't you just be able to develop a new one? Unfortunately, the situation with antibiotics is a little more complicated. A quick look at history shows why, and a longer look into the future shows how scientists are dealing with the problem.

“We are already seeing infections that are resistant to all antibiotics - that is known. So we have to work extremely hard to preserve the drugs that are critical to human health and enable research and development of new drugs. "