Antimicrobial agents – optimising the ecological balance

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Background:
There is no more challenging a group of pharmaceuticals than antimicrobials. With the antibiotic era came great optimism as countless deaths were prevented from what were previously fatal conditions. Although antimicrobial resistance was quickly identified, the abundance of antibiotics entering the market helped cement attitudes of arrogance as the “battle against pestilence appeared won”. Opposite emotions soon followed as many heralded the return of the pre-antibiotic era, suggesting that the “antibiotic pipeline had dried up” and that our existing armament would soon be rendered worthless.

Discussion:
In reality, humans overrate their ecological importance. For millions of years there has been a balance between factors promoting bacterial survival and those disturbing it. The first half century of the “antibiotic era” was characterised by a cavalier attitude disturbing the natural balance; however, recent efforts have been made through several mechanisms to respond and re-strengthen the antimicrobial armament. Such mechanisms include a variety of incentives, educational efforts and negotiations. Today, there are many more “man-made” factors that will determine a new balance or state of ecological harmony.

Conclusion:
Antibiotics are not a panacea nor will they ever be inutile. New resistance mechanisms will be identified and new antibiotics will be discovered, but most importantly, we must optimise our application of these extraordinary “biological tools”; therein lays our greatest challenge – creating a society that understands and respects the determinants of the effectiveness of antibiotics.

Keywords:
Antibiotic stewardship, Antibiotic policy, Antibiotic pipeline, Antimicrobials Antibiotics

Autoři: Sze-Ann Woon ¹; Dale Fisher ^1,2,3*
Působiště autorů: Division of Infectious Diseases, University Medicine Cluster, National University Hospital, Singapore, Singapore. ¹; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. ²; National University Health System, NUHS Tower Block, 1E Kent Ridge Road, Level 10, Singapore 119228, Singapore. ³
Vyšlo v časopise: BMC Medicine 2016, 14:114
Kategorie: Opinion
prolekare.web.journal.doi_sk: https://doi.org/10.1186/s12916-016-0661-z

© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The electronic version of this article is the complete one and can be found online at: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0661-z

Souhrn

Keywords:
Antibiotic stewardship, Antibiotic policy, Antibiotic pipeline, Antimicrobials Antibiotics

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