Today (18th November), marks the beginning of World Antimicrobial Awareness Week 2022, a global campaign created to highlight the increasing threat of drug resistance in antibiotics and other antimicrobial medicines, and drive innovation to reduce its spread.
The WHO has assigned priority levels to microbes based on several factors, including clinical impact, incidence, transmissibility and availability of effective antibiotics.
Between 2012 and 2017, deaths due to antimicrobial resistance decreased by 18% overall and nearly 30% in hospitals. However, as the pandemic pushed healthcare facilities, health departments, and communities near their breaking points in 2020, a significant increase in antibiotic use was observed.
In 2019, antibiotic resistance was directly responsible for ~1.27 million deaths and antimicrobial resistant infections playing a role in ~4.95 million deaths globally. This is greater than the number of deaths caused by HIV/AIDs (84k) or Malaria (643k) within that same year.
From March to October 2020, almost 80% of patients hospitalised with COVID-19 received an antibiotic. This, coupled with difficulty in following infection prevention and control guidance, resulted in an increase in healthcare-associated, antimicrobial-resistant infections and deaths.
Overall, increased AMR-related deaths were observed for all WHO critical priority pathogens: Acinetobacter; Pseudomonas; Enterobacterales; and Candida.
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While new classes of antibiotics have been produced to target different bacterial components, these may still eventually be impacted by resistance. Therefore, it is imperative that novel antibacterial treatments are developed to ensure longevity and continued efficacy.
Monoclonal antibodies currently make up the largest group of ’non-traditional agents’ against antibiotic-resistance bacteria. Other novel treatments have been developed, particularly Phage therapies, antibacterial polymers, and treatments utilising CRISPR technology. However, these agents will take a significant period of time to come to market, with the majority of candidates still in preclinical development or early stage clinical trials.
There are also currently 63 vaccine candidates in clinical development for antibiotic resistant bacteria, but none for any fungal pathogens. This is despite vaccines being an effective tool to combat antibiotic resistance as they reduce the incidence of infection while decreasing antibiotic use. Additionally, vaccines target multiple epitopes on pathogens unlike antibiotics, which target a specific site, so the chance for developing resistance is lower.
Several priority pathogens do not have any late-stage clinical candidates, further highlighting the critical need for data-driven strategies to drive further investment and research advancement.
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