Combating Antimicrobial Resistance: Going Beyond New Antibiotics

Abstract

At the outset of 2020 and prior to coronavirus disease 2019 usurping our attention, the discussion among infectious disease practitioners was focused on the alarming increases in multidrug (antimicrobial)-resistant organisms (MDROs). 1 Antimicrobial resistance had been identified by the Obama administration as a global threat that warranted issuance of a national action plan which outlined needed steps to confront this threat. 2 Although most have looked to new antibiotics as the primary means to combating resistance, this strategy is flawed for many reasons. Given that most antibiotics were originally derived from fungi and other bacteria, bacterial resistance to antibiotics is an evolutionary strategy that has existed since the beginning of time. Market forces do not favor the development of antibiotics, which are used for short periods of time and are often subjected to restricted use to prevent emergent resistance. 3 This means that the profit potential is lower for antibiotics compared with other agents. The Infectious Diseases Society of America has long drawn attention to the dearth of antibiotics in development and has advocated for multiple measures to increase the incentives for antibiotic production. 3e5 For these reasons, efforts to tackle antimicrobial resistance need to go beyond just new antibiotics. Thus, this month's Specialty Update focuses on "Combating Antimicrobial Resistance: Going Beyond New Antibiotics." When considering the major drivers of antimicrobial resistance, most people tend to focus on the medical uses of antibiotics. The sad truth is that the volumes of medical use of antibiotics are dwarfed by the enormous quantities of antibiotics used in animal food production. 6 Several studies have highlighted the presence of MDROs in meat and poultry found in grocery stores. 7,8 Limiting the use of antibiotics in this realm would go a long way to reducing the emergence of MDROs. Dr. Sameer Patel and co-authors review the current state of antibiotic use in animal food production and highlight strategies to expand antimicrobial stewardship into this arena. 9 They specifically highlight the concept of the "One Health" model and write:

Queer Ecologies and Anti-Colonial Abundance in Lionel Wendt's Ceylon

“…94 As Jhaveri points out, Wendt used experimental techniques to picture a country and its people who had previously been largely portrayed in ethnographic or picturesque terms by photography. 95 Although certain commentators have read Wendt and the 43 Group as somehow foreign to the island due to their engagement with European modernism, Sri Lanka had an indigenous practice of temple mural painting in the 1930s described by some scholars as 'surrealist'. 96 Wendt's dialogue with French surrealism in particular was complex, given that the movement pursued a range of cultural strategies, from racist primitivist tropes to anti-colonial claims.…”