Antimicrobial Resistance (AMR) is a condition in which bacteria, viruses, fungi, and parasites evolve over time and cease to respond to antibiotics, making infections more difficult to cure and raising the risk of disease transmission as it then associated with being a life-threatening sickness and/or even death. Drug resistance makes it harder or impossible to treat illnesses and renders antibiotics and other antimicrobial medications useless.
Antimicrobial Resistance Causes
AMR develops throughout time, typically as a result of genetic alterations. People, animals, food, plants, and the environment (in water, soil, and air) all include antimicrobial resistant microbes. They can transmit from person to person, through humans and animals, or even via animal products in food. The misuse and overuse of antibiotics, a lack of access to clean water, sanitation, and hygiene (WASH) for humans and animals, inadequate infection and disease prevention and control in hospitals and farms, a lack of access to high-quality, reasonably priced medications, vaccines, and diagnostics, a lack of awareness and knowledge, and a lack of legal enforcement are the main causes of antimicrobial resistance.
AMR has grown to be a significant worldwide health issue because it jeopardises our capacity to successfully treat infectious diseases, such as bacterial infections like tuberculosis, pneumonia, and urinary tract infections. It poses a serious problem in hospital settings as well since resistant infections can easily spread among patients, causing outbreaks and higher rates of morbidity and mortality.
The abuse and excessive use of antibiotics in human medicine, agriculture, and animal husbandry are just a few of the factors that contribute to the growth and spread of antimicrobial resistance. Furthermore, the issue is made worse by the paucity of new antimicrobial medications being created.
Antimicrobial resistance has been identified as a global health concern by the World Health Organisation (WHO), and other international organisations are trying to develop ways to tackle this growing threat and protect the efficacy of antimicrobial medications for both the present and the future generations.
There are no novel antimicrobials in the clinical pipeline. Only six of the 32 antibiotics that address the WHO list of priority infections that were listed by WHO as being in clinical development in 2019 were considered novel. Access to high-quality antimicrobials also continues to be a big problem. All levels of development are being impacted by antibiotic shortages, particularly in health care systems.
Impact
As medication resistance increases internationally, making diseases harder to cure and ultimately to mortality, antibiotics are becoming less and less effective. According to the WHO priority pathogen list, new antibiotics are urgently needed, for instance, to treat carbapenem-resistant gram-negative bacterial infections. However, these novel medicines will experience the same fate as the present antibiotics and become useless if people do not change the way antibiotics are used currently.
AMR has a substantial financial impact on national economies and health systems because it reduces patient or carer productivity by necessitating longer hospital stays and more expensive, intensive treatment.
The number of people whose treatment is failing or who pass away from illnesses will rise in the absence of efficient methods for the prevention and sufficient treatment of drug-resistant diseases, as well as enhanced access to current and novel antimicrobials with high levels of quality assurance. Surgery, including caesarean sections or hip replacements, cancer chemotherapy, and organ transplants will all become riskier medical procedures.
AMR continues to rank among the top 10 worldwide public health hazards to humanity, killing 4.95 million people in 2019. AMR poses a threat to the world economy as well, with effects on expected global trade, health care expenses, and productivity. By 2050, AMR could have cost the global economy USD 100 trillion if nothing is done.
Thus, the One Health strategy is being used by the Global AMR R&D Hub, a cooperation of nations, non-governmental donor organisations, and intergovernmental organisations, to address difficulties and enhance coordination and collaboration in global AMR R&D.
India introduced the National Action Plan on Antimicrobial Resistance (NAP-AMR) in 2017 to address the growing danger posed by AMR. The plan’s main objectives are to encourage the responsible use of antibiotics, improve infection prevention and control practises, fortify surveillance and monitoring systems, and foster the discovery of new antimicrobial medications.
The Red Line Campaign too was started by the Indian government and a number of partners to educate the public about the proper use of antibiotics. The campaign attempts to promote good prescription practises and prevent the over-the-counter buying of antibiotics.
Consequences
The critical consequences that antimicrobial resistance (AMR) poses for public health, healthcare systems, and overall global wellbeing are numerous. AMR has a number of major issues, some of them are as follows:
Limited Treatment Options: As microorganisms develop resistance to commonly used antimicrobial drugs, treatment options for infectious diseases become limited. This can lead to longer and more severe illnesses, making it difficult to manage infections effectively.
Increased Morbidity and Mortality: AMR can result in higher rates of treatment failure, increased complications, and longer hospital stays. It can also lead to a higher risk of death from infections that were once easily treatable.
Healthcare Costs: The increased burden of drug-resistant infections places a significant financial strain on healthcare systems. The need for more extensive and prolonged treatments, additional diagnostic tests, and the use of expensive second-line drugs can escalate healthcare costs.
Infections in Vulnerable Populations: Vulnerable populations, such as the elderly, young children, and people with compromised immune systems, are at higher risk of contracting drug-resistant infections. This can lead to higher morbidity and mortality rates in these groups.
Spread of Infections: AMR can facilitate the rapid spread of infectious diseases within healthcare facilities, communities, and even across international borders. This poses a significant public health threat and makes disease containment more challenging.
Impact on Agriculture and Food Safety: AMR can also affect the agriculture sector, as antibiotics are commonly used in animal husbandry. Resistant bacteria in animals can transfer to humans through food consumption, posing a risk to food safety and public health.
Lack of New Antibiotics: The development of new antimicrobial drugs has slowed down significantly, leading to a “discovery void.” Few new antibiotics are being developed, and the pipeline for innovative drugs is limited, making it challenging to stay ahead of emerging resistance.
Cross-Resistance: Some microorganisms may develop resistance to multiple classes of antimicrobial drugs, leading to cross-resistance. This further restricts treatment options and makes infections more challenging to manage.
Global Impact: AMR is a global issue that requires international collaboration. Resistant bacteria can spread across borders through travel and trade, making it crucial for countries to work together to address the problem.
Threat to Modern Medicine: Antimicrobial resistance jeopardizes the effectiveness of many modern medical interventions, such as chemotherapy, surgeries, and organ transplants. Without effective antibiotics, these procedures become riskier and less feasible.
Addressing antimicrobial resistance requires coordinated efforts from governments, healthcare professionals, researchers, pharmaceutical companies, and the public. Implementing appropriate infection prevention and control measures, promoting responsible antibiotic use, investing in research and development of new drugs, and raising awareness about AMR are essential steps in mitigating the challenges posed by this global health threat.
Position of the Antimicrobial Resistance Market
The global antibiotic resistance market size was evaluated at USD 8.13 billion in 2022 and is predicted to increase at a compound annual growth rate (CAGR) of 5.7% from 2023 to 2030. The increasing incidence of antibiotic-resistant illnesses across developed & emerging regions and a shift in prescription patterns to newly released medicines are the primary drivers of the market.
Respiratory infections make up the largest portion of the market for antibiotic resistance. Numerous illnesses fall under the category of respiratory infections, including pneumonia, bronchitis, and sinusitis, among others. Bacterial pathogens like Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae are frequently to blame for these infections. Standard antibiotics are less effective against respiratory bacteria due to antibiotic resistance, which results in treatment failures and more serious sickness. This has increased the demand for alternative medical procedures and sped up the creation of fresh antibiotics that target respiratory bacteria.
Urinary tract infections (UTIs) are the market category with the fastest rate of growth for antibiotic resistance. Men and women alike are susceptible to UTIs, one of the most prevalent bacterial diseases. Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis are the three main pathogens responsible for UTIs. Many antibiotics are no longer effective due to resistance mechanisms as carbapenemases and extended-spectrum beta-lactamases (ESBLs). New treatment approaches, such as combination therapy and the investigation of novel antibiotics, have been developed in response to the rising incidence of UTIs that are multidrug resistant.
The market sector for beta-lactam antibiotics has the biggest market share. Penicillins and cephalosporins are examples of beta-lactam antibiotics that are frequently used to treat a variety of bacterial infections. Because of its wide range of activity, effectiveness against a variety of common bacterial infections, and comparably cheaper cost compared to other medication classes, beta-lactams have a large market share.
On the other hand, the fluoroquinolones class is the area of the antibiotic resistance industry that is expanding the fastest. Broad-spectrum antibiotics called fluoroquinolones stop bacteria from synthesising DNA. They are frequently used to treat gastrointestinal, urinary tract, and respiratory infections. Fluoroquinolone antibiotics are no longer as efficient against bacterial strains having mutations in the DNA gyrase and topoisomerase genes. Fluoroquinolones are still widely used because of their effectiveness and extensive coverage against a variety of bacterial infections, despite the difficulties posed by resistance.
As the problem of antibiotic resistance grows, the pipeline for new antibiotics is very small. The creation of new antibiotics is a difficult and complex process that demands a lot of money, effort, and knowledge. Antibiotic development has, however, decreased as a result of issues such the high cost of research and development, regulatory difficulties, and the poor return on investment. It highlights the urgent need for enhanced efforts and incentives to drive the development of novel medicines and shows how the lack of new antibiotics makes it difficult to treat infections that are resistant to antibiotics.
In 2022, the antibiotic resistance market was dominated by the North American region, accounting for more than 42.0% of the total. The high prevalence of antibiotic-resistant Gram-negative infections and new initiatives to combat drug resistance are boosting the region’s growth. Additionally, it is anticipated that regional insurance laws and government initiatives would fuel expansion in the upcoming years.
From 2022 to 2030, the Asia Pacific area is expected to experience the strongest growth. Antibiotic overuse and unrestricted sales are the main factors fueling market expansion in developing countries like China and India. The Asia Pacific region consumes the most antibiotic medications globally, which raises the possibility of acquiring diseases with high antibiotic resistance. Due to the excessive consumption of antibiotics and the absence of efficient antibiotic stewardship strategies, drug-resistant diseases are still on the rise in the area.
The market for antibiotic resistance is characterised by a combination of well-known pharmaceutical corporations, up-and-coming biotechnology companies, and research organisations actively tackling the problem of antibiotic resistance on a worldwide scale. Strategic partnerships, product launches, mergers and acquisitions, research and development, and other initiatives are just a few of the actions that major market players engage in to advance innovation and enhance their market positions.
Key companies include: Pfizer Inc., Johnson & Johnson, Novartis AG, GlaxoSmithKline, Achaogen Inc., AstraZeneca, Bayer AG among many others.
Conclusion
There is a growing understanding that relying exclusively on traditional antibiotics may not be adequate to address the problem as a result of the growth in antibiotic resistance. As a result, there is a trend towards investigating and creating different strategies to deal with bacterial diseases. For instance, Phage therapy, which uses bacteriophages (viruses that infect and kill bacteria) to target and eradicate antibiotic-resistant germs, is one important development. By concentrating on the harmful bacteria while sparing the helpful microbiota, phage therapy is a potential means of combating drug resistance.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768623/
https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
https://www.grandviewresearch.com/industry-analysis/antibiotic-resistance-market
https://www.skyquestt.com/report/antibiotic-resistance-market
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783766/
https://www.persistencemarketresearch.com/market-research/antibiotic-resistance-market.asp
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