Antibiotics were one of the most significant medical breakthroughs in the 20th century. Through the prudent management of these medical marvels, potentially lethal infectious diseases were rendered treatable. Nevertheless, the misuse and overuse of antibiotics have led to an evolving challenge known as antimicrobial resistance (AMR). In the face of uncontrolled spread of AMR, once treatable diseases risk becoming untreatable again. However, primary care physicians, at the frontlines of healthcare, can contribute significantly to mitigating this growing health threat.
Antimicrobial resistance has been recognized by experts as one of the most impending health crises of the 21st century. This constitutes a global problem requiring cooperative solutions at the international, national, and local levels. This was the message conveyed by Priya Nori, MD, the medical director of antimicrobial stewardship at the Montefiore Health System in the Bronx, New York, in her discussion with Medical Economics detailing the state of AMR within the medical industry in the late 2024 and early 2025.
Dr. Nori presented her understanding of AMR from both a broad societal and public health viewpoint to a narrower perspective of individual patients and healthcare facilities. She emphasized the severity of the issue by citing recent alarming AMR statistics. A prominent study ‘Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050,’ published by The Lancet in 2024, reported that AMR accounts for over a million deaths annually. This number is expected to almost double by 2050. It is the elderly population of 70 and above, particularly those in lower and middle-income countries, who are most affected.
Several factors contribute to the differing impacts of AMR. These factors include the healthcare infrastructure (focused on antibiotic stewardship and infection prevention), surveillance programs for AMR, hand hygiene programs, and varying access to healthcare resources depending on the country. Apart from the human cost, the financial cost of AMR is equally enormous. Predicted to run into trillions in the next decade, it is already costing billions of dollars a year, particularly in countries like the USA.
However, conditions caused by AMR are largely preventable with robust antibiotic stewardship, quality hand hygiene, and efficient vaccination programs. These measures would significantly reduce the burden of AMR. Several socioeconomic issues contribute to a higher AMR burden. This includes areas of human conflict, displacement due to poor living conditions, and lower vaccine uptake. A decline in vaccine coverage could trigger an increase in antibiotic use as more people present with infectious conditions, leading to expanded exposure to antibiotics.
Moreover, extensive antibiotic use extends beyond human health into livestock and agriculture. This rampant usage not only breeds resistant strains in animals but also in consumers of these products, illustrating the concept of One Health – all health (environmental, animal, and human) is interconnected.
Focusing in particular on hospital levels and individual patients, Dr. Nori highlights that we can exert more control in these specific areas. Infection prevention and control programs, coupled with antibiotic stewardship programs, are instrumental in mitigating AMR by reducing antibiotic overuse, preventing the spread of antibiotic-resistant instigators, and curtailing the occurrence of health care associated infections. These programs support frontline providers in all health care environments, aiding in patient safety and preventing antibiotic resistance.
The fight against AMR requires interventions at all levels and it’s clear that much work needs to be done. Through collective efforts, we stand a better chance of safeguarding our current medical victories and ensuring a healthier future for all.
Source: https://www.medicaleconomics.com/view/antimicrobial-resistance-analyzing-a-global-health-threat