Global antibiotic use is rising, spurring more antibiotic resistance

Antibiotics made their big debut during World War II, when the U.S. pumped out increasingly potent doses of penicillin to successfully combat bacterial infections in troops.

These antibacterial drugs have been hugely effective in the seven decades since, but there's a consequence: The more that antibiotics are consumed, the more resistant infectious bugs become to these drugs, possibly giving rise to "superbugs" that are resistant to known treatments.

Today, the problem is global and on the rise, according to a study published Monday in the journal Proceedings of the National Academy of Sciences.

SEE ALSO: Doctors find virus in a pond, use it to destroy antibiotic-resistant bacteria in man's heart

After examining antibiotic use in 76 countries between the years 2000 and 2015, public health researchers found that the rate of antibiotic consumption had increased by almost 40 percent. The total number of estimated doses taken jumped by 65 percent in 2015 by comparison to those taken in 2000.

These are big jumps, but some sort of global increase was expected, as "economic growth leads to the ability to purchase all sorts of things which includes antibiotics," Eili Klein, an assistant professor in the Department of Emergency Medicine at John Hopkins Medicine and coauthor of the study, said in an interview.

Geneticist Chris Mason swabs a New York City subway rail to collect samples for antimicrobial resistance research in 2016. Credit: Getty Images for Weill Cornell Medicine

Although high-income countries like the U.S still consume the most antibiotics, the greatest increase in use since 2000 has been in middle and lower income countries, places like Turkey, Algeria, Egypt, and Tunisia. But the problem, regardless of how rich a nation is, remains the same.

"A lot of the use [of antibiotics] is inappropriate," said Klein.

People regularly take and are prescribed antibiotics for ailments that do nothing to improve their health, said Klein. Antibiotics are often consumed to treat viruses (antibiotics have no effect on viruses), and Klein said they're sometimes even given for asthma (an allergic reaction).

"We’ve been gluttonous about our use and had the luxury of having antibiotics available," said Tim Wencewicz, a chemist at Washington University in St. Louis who researches antibiotic resistance, in an interview. Wencewicz had no involvement in the study.

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But stopping antibiotic use is not the solution, said Klein, emphasizing that it's absolutely a great boon for people in lower-income countries to be able to afford the drugs. The solution is ensuring that lower and middle income nations don't abuse and misuse antibiotics, as is done in the high-income countries.

"We don’t want these counties to fall into the same trap of overprescribing antibiotics," said Klein.

There's no magic bullet for decreasing consumption.

"If this was an easy problem it would have been solved," said Wencewicz.

An image of the strain of Penicillium notatum that Alexander Fleming discovered at St. Mary’s Hospital in London in 1928. Credit: fda

But one important solution is stopping diseases before they can start.

"Many of these diseases are preventable," said Klein, who explained that infrastructure projects that ensure clean, feces-free water lead to widespread improvements in public health (like they did in the U.S.).

Another solution is to increase the availability of vaccines. Although vaccines have no effect on bacterial infections, simply not being stricken with viral infections would mean that fewer people would be inappropriately perscribed antibiotics to treat the infection.

One of the greatest fears of antibiotic resistance is the evolution of a superbug.

These types of antibiotic-resistant superbugs have already evolved. In December 2016, for example, a woman had an infection resistant to every antibiotic the hospital had -- 26 types-- and died.

New antibiotics can't just be created on a whim, and pharmaceutical companies have little incentive to develop the drugs. It takes over 25 years for mainstream, wide-spectrum antibiotic drugs to make a profit, said Wencewicz.

But Wencewicz said he refuses pessimism. There are innovative engineers working on novel drug solutions meant to defeat resistant bacteria in ways that "think outside the box." Wencewicz's lab, for example, is working on how to starve bacteria, specifically by stopping it from acquiring iron. "That's sort of an Achilles heel for bacteria," he said.

Klein and his researcher team measured antibiotic use until 2015, and there's no reason to think the upward trends aren't continuing now.

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