How countries can curb antibiotic resistance


New Delhi: The proliferation of disease-causing antibiotic resistant organisms is correlated with many social and environmental factors such as poor sanitation, unsafe water and higher corruption, a study published in the Lancet Planetary Health, has showed.

The study, led by researchers from the Centre for Disease Dynamics, Economics and Policy (CDDEP), here, showed that better infrastructure and better governance were significantly associated with lower measures of antimicrobial resistance.

Good governance includes lower corruption, political stability, rule of law, and absence of violence; while infrastructure measures include sanitation, safe water, internet accessibility, urbanisation, and access to electricity.

Although the use of antibiotics is commonly known to drive the emergence and maintenance of antimicrobial resistance, the team found that antibiotic consumption was not significantly associated with higher antimicrobial resistance.

Reducing antibiotic consumption is insufficient to control antimicrobial resistance because contagion–the spread of resistant strains–seems to be the dominant factor, the researchers said.

“While reducing antibiotic consumption is important, we have to remember that resistance genes are already widely disseminated in the environment,” said Ramanan Laxminarayan from the Centre.

“Preventing transmission of resistant pathogens through investments in improved water and sanitation, and primary healthcare are central to our ability to tackle antimicrobial resistance.”

The study, based on economic and public health data from 73 countries, found that countries with higher corruption and less spending on public health infrastructure have higher rates of antibiotic resistance

“There are not magic bullets here,” Laxminarayan said. “Any new antibiotic will run into the same challenges as existing ones and resistance will emerge rapidly unless we take the problems of improving the health system head on.”

Thus, improving sanitation, increasing access to clean water, and ensuring good governance, plus increasing public health expenditures, all need to be addressed to reduce global antimicrobial resistance, the researchers said.