Antimicrobial resistance is one of the greatest challenges of human health in general, and the field of infectious diseases in particular. It is – at its most basic level – an “arms race” between humans developing effective (and safe) antimicrobial compounds for the treatment of infections, and microbes developing or acquiring resistance determinants to these compounds. For a variety of reasons – well documented elsewhere in this Nature pictorial by Hede and the Infectious Disease Society of America (IDSA)’s 2004 policy document – the microbes have pulled ahead in this race. And there is no “reset button”. The stakes have also become intolerably high, because so much of modern medicine (cancer chemotherapy, advanced surgery, organ transplantation, among others) has been built on the premise that infections can be prevented or treated with antibiotics. Even at this point, where the vast majority of bacterial infections can still be cured with appropriate antibiotic therapy, the presence of antimicrobial resistance has meant that more expensive and/or toxic antibiotics are required, resulting in greater healthcare costs, morbidity and mortality.

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Antimicrobial resistance