Global action required to combat antimicrobial resistance

In an article published by the University’s policy engagement unit, Policy@Manchester, Dr Michael Bottery, Professor Michael Brockhurst, Professor Lucie Byrne-Davis, Professor Michael Bromley and Dr Wendy Thompson caution that increasing levels of antimicrobial resistance (AMR) mean many frontline medicines are losing effectiveness for treating many bacterial, viral, fungal, and protozoal infections such as malaria. 

The authors set out several reasons explaining the origins of AMR including the use of antibiotics and antifungals in agriculture, a disjointed approach to regulation and licensing of antimicrobials, and a 25 per cent increase in antibiotic prescriptionsby dentistsduring the pandemic. 

“COVID-19 sharply demonstrated that diseases are not limited to a single nation and tackling antimicrobial resistance requires global cooperation,” they write. “As a start, international bodies like the UN, WHO and the EU should provide detailed guidance on the use of antimicrobials in agriculture. This should include risk assessments on the likelihood of cross-resistance evolving because of the dual use of the same types of antimicrobials across agriculture and the clinic.”  

The academics call on regulators to ensure that “before a new antimicrobial is permitted for commercial use, independent assessment has been made of the potential impact on clinical use.”  They add: “In the UK, this will require cooperation between the Environment Agency, the Medicines and Healthcare products Regulatory Agency (MHRA) and the UK Health Security Agency; establishment of a cross-agency working group would help to facilitate this.” 

Drawing on their own research, they explain that the spike in antibiotic prescriptions in dentistry was driven by “system-level influences, which left dentists feeling frustrated that they were unable to provide safe and effective care in line with clinical guidance.” They continue: “Targets for optimising antibiotic prescribing into the future should be at the system (commissioner) level and should focus on improving access to – and the delivery of – safe and effective care for people with acute dental problems.”  

The authors recommend that the UK’s future AMR strategy should be guided by research from The University of Manchester and others with the goal of “identifying new ways to help conserve the effectiveness of antimicrobials for future generations.” They write: “For their part, research bodies should aim to shape targets within, and support delivery of, the UK’s national AMR action plan and the WHO’s Global Action Plan on AMR, including through our global health research and education activities in low and middle income countries.” 

They conclude: “Antimicrobial resistance is an existential threat, and one that is intimately entwined with the risks posed by climate change and overconsumption. For AMR, as with the climate crisis and resource scarcity, the solution lies in a mix of new innovations, and smarter guarding of current assets.” 

‘Culture shift: Tackling antimicrobial resistance from agriculture to operating table,’ byDr Michael Bottery, Professor Michael Brockhurst, Professor Lucie Byrne-Davis, Professor Michael Bromley and Dr Wendy Thompson is available to read on the Policy@Manchester website.