UK health officials are warning of a "hidden pandemic" of antibiotic-resistant infections if people fail to act responsibly after Covid, as reported in BBC News today. University of Warwick experts at the forefront of antimicrobial resistance (AMR) research offer their comment:

Professor Chris Dowson has, for many years, examined the emergence and evolution of antibiotic resistance across a wide range of bacteria. His recent focus has been to better understand how penicillin targets bacteria.

"Antimicrobial resistance (AMR) continues to be a global problem. Although compared to COVID-19 AMR it is a silent pandemic, with patients suffering and dying from resistant organisms often going unreported.

"Levels of antibiotic resistance, like sea water continue to rise and erode our amazing advances in modern medicine – of which our discovery of antibiotics has been the most important.

"The 2020-2021 ESPAUR report flags trends in antibiotic resistance, infections and the prescribing levels of antibiotics across different sectors of health care. With reductions in some areas due to improved stewardship (careful monitored use) seen in primary care due prescribing campaigns supporting doctors to say ‘no’ to unnecessary prescriptions, but reduced also due to limited social interactions and reduced non-COVID bacterial infections during this period of the pandemic. However, within hospitals, respondents to the ESPAUR survey believed that COVID had a negative impact on routine antibiotic stewardship activities and antibiotic prescribing in dentistry had increased.

"There is a worrying trend with the ongoing rise of resistance in E. coli to the latest generations of penicillin like compounds (cephalosporins). This impacts our ability to treat complex urinary tract and blood stream infections.

"Finally, we can either be part of the problem in demanding antibiotics unnecessarily from our GPs, or part of the solution and take on board good advice to use antibiotics wisely."

--------------------------------------------------------------------------------------

Dr Freya Harrison is a microbiologist who works on chronic, antibiotic-resistant infections and tries to discover new antibacterial treatments.

"There is no antibiotic to which at least some bacteria have not evolved resistance. Bacteria can evolve resistance very quickly, because they reproduce rapidly and have high mutation rates. What we have to do is make it as hard as we can for bacteria to evolve resistance, and a big part of that is making sure that we use the right antibiotics, at the right dose, in the right time and place.

"When we don't finish a course of antibiotics, or give someone the wrong one, or we let antibiotics get into the wrong place (like rivers), we give bacteria just enough of a push to let resistant mutants spread, rather than killing them. The more bacteria that become resistant to a drug, the less useful that drug is to us as a medicine."

-----------------------------------------------------------------------------------------------

Dr Antonia Sagona researches the mechanisms of bacterial infection and phage therapy inside the mammalian cell environment, and is tackling the emerging problem of antibiotic resistance in many bacterial pathogens.

"The problem of antimicrobial resistance is growing dangerously over the last years and if we do not take efficient measures to avoid it, we will have a crisis. The problem stems from the fact that bacterial pathogens become resistant to antibiotics gradually, due to antibiotics’ overuse and the infections caused by these multi-resistant pathogens cannot be treated with the regular treatments, putting in high risk the patients live. Τhis is particularly prominent in hospital settings, where they reside many multi-resistant bacteria, causing threat for patients.

"According to the first paper published by the Review on Antimicrobial Resistance (http://amr-review.org), drug-resistant infections are expected to kill an extra 10 million people across the world every year by 2050 if a solution is not found and by this date they could also cost the world around $100 trillion in lost output, which is more than the size of the current world economy and roughly equivalent to the world losing the output of the UK economy every year for 35 years. Especially after the covid crisis, great care is needed to avoid this problem.

"The first step is the realization that the bacterial pathogens become resistant to antibiotics and therefore the use of antibiotics will need to be monitored very carefully and these need to be prescribed only, when necessary, to tackle serious bacterial infections. Care needs to be taken and hygiene measures need to be followed especially this winter, to avoid the spread of bacterial infections. Finally, alternative solutions to antibiotics can be used when necessary. One such solution is phage therapy, the use of bacteriophages-viruses that target specific bacteria-to tackle bacterial infections. The combination of bacteriophages with antibiotics has been found to be efficient in tackling drug-resistant bacterial pathogens. In our lab in the University of Warwick and in collaboration with consultants, we do relevant research with very good results so far."

----------------------------------------------------------------------------------------

More info on the Warwick Antimicrobial Interdisciplinary Centre:

https://warwick.ac.uk/fac/cross_fac/wamic/

17 November 2021

For interviews and further quotes, contact:

Luke Walton, International Press Manager

L.Walton.1@warwick.ac.uk

+44 (0) 7823 362 150