55. Drug Resistance

Abstract

The control of infectious diseases is seriously threatened by the steady increase in the number of microorganisms that are resistant to antimicrobial agents. Once resistance has emerged in a population, it can spread both geographically and between age groups. The problem is particularly severe in developing countries, where patients have less access to or are unable to afford second–line treatments. Because these are typically more expensive, the economic impact of drug resistance in developing countries may be substantial. Factors that contribute to disease, such as poor hygiene and unreliable water supplies, exacerbate the problem.

Interventions to address the problem of drug resistance are often the same as those that reduce the burden of disease. Reducing disease diminishes the need for drug treatment, which lowers the likelihood that resistant strains will emerge. In addition, the appropriate choice of drug treatment is an important step in delaying the evolution of drug resistance. Education, professional accountability, and improved communication between patients and providers are necessary.

Antimicrobial resistance is a global challenge. It is important for governments to ensure that the effectiveness of our current arsenal of anti–infectives is not depleted too rapidly. Sustaining gains in life expectancy by means of the introduction of effective drugs to treat infectious diseases requires a willingness to invest in interventions both to extend the therapeutic life of existing drugs and to discover and develop new ones.