September, 13 – birthday of penicillin


К списку новостей

September, 13 – birthday of penicillin

Triumph of the invincible?
Anton Zybin, Director General of Lancet Plc:
Water is a source of antibiotics

Antibiotics banished fear of infections in people and saved millions of lives. But people disposed inestimable blessing careless and bred the bitterest enemy - antibiotic resistance, that is microorganisms resistance to antimicrobial medicines. Currently antibiotic resistance is acknowledged to be a global problem of humanity.

There is a reason to consider that more than 50 % of antibiotics on different countries are used without control and off-label. For instance, people try to treat viruses with antibiotics, given that they treat bacterial infections only, use more broad-spectrum medicines, do not follow therapeutic regimen and duration of medicines administration.

Food products contain residual amounts of antibiotics as these medicines are used in veterinary, agriculture, fish farming. Water is another source of antibiotics. Medicines run into rivers with human, animal wastes, from sewage treatment facilities, from pharmaceutical enterprises waste.

Results of worldwide river water research were published in May, 2019 at SETAC Europe 29th Annual Meeting which took place in Finland. Enhanced concentrations of antibiotics were registered in 80 % of samples taken from rivers located in more than 70 countries on different continents. Limits could be exceeded 300-fold. The worst situation turned out to be in Africa. While “laurels” of the dirtiest rover in the world were awarded to Ravi River at the banks of which Lahore – Pakistan capital – is Europe sorrowful superiority was assigned to Danube.
Silent war with “loud” consequences

The danger of uncontrolled spread of antibiotics lies in the fact that bacteria adapt to medicines and become insusceptible to them. With the advent of such “super bugs” people can find themselves at the mercy of deadly disease. Even a simple scratch  can result in lethal outcome, not to mention surgery, transplantology, other serios interventions.

Surely new antibiotics are being developed in the world. But 10 – 25 years may pass from development to introduction, while microorganisms are able to develop insusceptibility to them during one year.

Without systemic approach to this problem according to the UN projections by year 2050 people will die of infections much more often than of oncological and cardiological problems. Nowadays more than 700 thousand lethal outcomes are registered annually due to antimicrobial year 2050 the number of victims can grow up to 10 millions of our planet inhabitants.

One of the major contemporary problems has moved far beyond medical issues. In many countries significant economic damage to healthcare systems has been registered. According to the projections by year 2050 global GDP gap due to antimicrobial resistance will count as much as 8 %.  

The problem of uncontrolled use of antibiotics is so much serious that nowadays antibiotic resistance is perceived worldwide as a threat to national security. The World Health Organization has initiated a global campaign on reduction of the spread of antimicrobial drugs resistance and pushed governments of world countries for participation in it.

In Russia relevant strategy up to year 2030 was adopted in 2017, and a plan for this Strategy implementation was approved in March, 2019.

To a hospital for health, not to get infection  

One of the most topical healthcare issues is the prevalence of hospital-acquired infections. Due to violation of infection control measures and inadequate use of antibiotics resistance of pathogenic microorganisms to them in hospitals is on the fast track. This provokes such serious infections as hospital-acquired pneumonia, bloodstream infections, wound or surgical site infections and etc.

According to official source data infections related to healthcare delivery effect 5 % to 15 % of hospitalized patients, while in high risk departments - resuscitation and intensive care departments the figure may be as high as 40 %. Such patients stay at hospital 2-3 times longer, the cost of their treatment increases 3-4-fold, while the risk of lethal outcome increases by 5-7 times.  

The company Lancet in the partnership with transregional civil organization Russian Sepsis Forum has been delivering the project “Efficient in-patient facility” since 2017. The project participants include several multi-specialty hospitals in different Russian cities which get personified recommendations from the leading federal and international level experts after complex analysis.  Their implementation allows to control the prevalence of hospital-acquired infections, to prevent development of severe complications such as sepsis which is the leading cause of lethal outcomes in patients with hospital-acquired infections, to improve treatment results, decrease lethality and MPI expenses on complications treatment.

“Superbugs” have already become the reality
Superbugs resistant even to protected antibiotics and ultra-broad spectrum antibiotics are not fiction any more.  

The problem of safe and effective use of antibiotics should be solved in a complex – starting from large-scale distribution of information among population on prudent use of antibiotics and by medical prescription only, raising the level of healthcare personnel education – to strict control of antibiotics turnover in the fields related to food products manufacture, and state support of studies on development and manufacture of innovative antimicrobials.