January 24, 2019

expert reaction to government plan for containing and controlling AMR

Reactions to new government plan for containing and controlling AMR.

Dr Andrew Singer, Environmental Microbiologist, Centre for Ecology & Hydrology, says:

“It is encouraging that the action plan recognises an improved evidence base on AMR in the environment, which will be a UK priority over next five years.”

“At present, there is a key knowledge gap in our understanding of the pathways in which AMR is transmitted between the environment, animals and humans, and more research on this is needed in order to design effective interventions and reduce risk.

“The most likely source of risk at present are sewage works across the world that chronically release antibiotics and antibiotic-resistant bacteria into nearly all rivers. The goal should now be to identify the major sources of antimicrobial resistance and put in place interventions that are fit for purpose.

“We hope ambition will lead to action and we will not wait until the end of the five-year plan for proposals on interventions in key areas of our environment, such as wastewater, animal production and agriculture.”

Dr Mark Webber, Quadram Institute Bioscience, said:

“It is welcome to see the government’s recognition of the importance of AMR as a threat to health and the identification of priority areas for future research. This builds on the progress made in the last five years to reduce antibiotic use in humans and animals and the efforts made to start integrating surveillance data to best understand where resistance is being selected and how resistant organisms and resistance genes move between bacteria and people.

“The national action plan for the next 5 years aims to consolidate the work already undertaken but also has a greater emphasis on the development of new therapies to prevent or rapidly identify infection and ideas about a new model to help develop novel antibiotics. This recognises the current inertia in drug development and the need for new antibiotics. The report emphasises the importance of basic research such as that undertaken within QIB to understand potential drug targets and the role of the microbiome. Antibiotic development is a global problem and the report states the UK will work with international partners to incentivise new antibiotic development, whilst the specifics are unclear the sentiment is positive although this is a major undertaking if relevant numbers of new drugs are going to be realised and this will not be a short fix.

“The recognition of the need for improved food safety and a better understanding of AMR in the food chain is highly relevant to ongoing work within QIB and we look forward to contributing evidence to help advance this knowledge base.”

Prof. Mark Woolhouse, Chair of Infectious Disease Epidemiology, University of Edinburgh, said:

“Today’s announcement by the UK Government represents a major step in the right direction if we are to avert a global disaster due to drug resistant infections. An important new feature of these plans is the setting of targets, both for reducing the use of antimicrobial drugs and for reducing the levels of resistance to these drugs. Achieving these targets will require a concerted and sustained effort: there is no easy solution to this problem and so we need to implement effective measures in our hospitals, at our GP surgeries and on our farms. There has been progress to date but levels of antimicrobial resistance continue to rise, so we need to do more.”

Dr Andrew Fenton, Research Fellow at the University of Sheffield, said:

“Reducing unnecessary use of antimicrobials is an important step in combating resistance.

“Antibiotic resistance carries the very real possibility of collapsing modern medical approaches; if deployed effectively this strategy will extend the life of antimicrobials we already have for future use. However, this is not a long-term solution to this challenge.

“Being wiser and more strategic in our antimicrobial use is an important first step to addressing this very broad issue.”

Dr Jonathan Betts, Research Fellow, University of Surrey, said:

“Antimicrobial resistance is a critical global issue and infections resulting from multidrug-resistant bacteria have become more frequent, leading to longer hospital stays, an increased financial burden to health services and higher rates of morbidity and mortality. This has been compounded by a marked decline in antibiotic development over the past 40 years, and some infections are now untreatable with conventional drugs.

“By increasing the resources for research and development of new antibiotics, improved diagnostics, infection control and antibiotic stewardship, it may be possible to avoid a ‘post antibiotic era’.”

Johnjoe McFadden, Professor of Molecular Genetics, University of Surrey, said:

“Antibiotic resistance in bacterial pathogens remains a major worldwide health concern for both human and veterinary medicine. Strains of bacteria that cause, for example, tuberculosis, that a few decades ago were mostly curable are now described as ‘drug resistant’, multidrug resistant’, ‘extensively drug-resistant’ or even ‘Totally drug-resistant tuberculosis TB’ resistant to 20 or more drugs.

“Similarly, MRSA strains are forcing hospitals to close wards or operating theatres in their battle against increasing numbers of resistant strains. The loss of options with affordable antibiotics is creating a huge burden for health services worldwide as physicians have to resort to expensive antibiotics that often require costly continuous monitoring, an option that isn’t available in developing countries. There patients are often treated with inappropriate drug regimens that only exacerbate the problem.

“The crisis is threatening to turn curable into incurable diseases and has the potential to return us to the pre-antibiotic era when patients could die of infections that are today considered trivial. Much needs to be done to prevent this catastrophe, including providing changes in prescribing practices, improvements in hygiene and restrictions on the use of antibiotics on the farm; but also supporting research to develop new antibiotics able to tackle resistant strains.”

Declared interests

Prof. Mark Woolhouse: “I have no conflicts of interest to declare.”

Dr Andrew Fenton: “No conflict of Interest.”

None others received.