Antibiotic resistance is an extensive problem whose control requires all available measures

Bacteria resistant to antibiotics are a silent pandemic of our time. The problem is complex, which is why solutions must be sought extensively. A better understanding of global antibiotic resistance is also needed.

Antibiotics are widely used: they are needed to both treat infections and prevent infections, for example, in connection with surgical procedures. Every third hospital patient receives antibiotics.

However, the efficacy of antibiotics is threatened by resistant bacteria. Antibiotic resistance affects our environment as a whole. In the United States, it kills approximately 35,000 people every year, and the same goes for the EU. In fact, because of its invisibility to us, antibiotic resistance has been called a silent pandemic.

What can we do if antibiotics stop working?

“Without antibiotics, we would not necessarily be able to treat common infections. Healing would take longer, which would cause human suffering. The most serious infections would result in death,” says Professor of Infectious Diseases, Senior Medical Officer Anu Kantele, speaking about the topic at the Pelastetaan antibiootit (‘Let’s save antibiotics’) event at Think Corner.

“Were antibiotics unavailable, we would take a great leap backwards in medicine,” Kantele adds.

Education and the importance of access to information emphasised in solutions

Antibiotic resistance is a problem associated with our common health. Since it affects both humans and animals as well as the environment, solutions must be sought from different perspectives.

“One important method is education: basic education and the training of doctors, veterinarians and microbiologists. Education is a wonder drug, but it works slowly. It requires persevering systematic action and money,” says Professor of Microbiology Marko Virta, speaking at the Think Corner discussion.

Kantele also emphasised the importance of access to information and the education of ordinary citizens. At the moment, not everyone in the world knows what antibiotics are.

“Finns are familiar with antibiotic resistance and know that unnecessary antibiotic therapies should not be taken. This way, cooperation between doctors and patients works well,” Kantele says.

How might responsible antibiotic use be promoted?

Particularly in developing countries, antibiotic resistance is spreading due to poor hygiene. Is it enough, then, to have water supply, hygiene and other basics of society in order?

Not according to researchers. In southern Europe, for example, the state of antibiotic resistance is worrying.

“We also need responsible use of antibiotics – in other words, using them only when necessary,” Virta notes.

From destination to home country, travellers carry in their guts bacteria resistant to antibiotics; but they too can do their part by acting responsibly.

“You can avoid travelling to countries with the highest levels of antibiotic resistance. The risk of getting resistant bacteria in your body is higher for those who develop traveller’s diarrhoea or take antibiotics. The risk can be mitigated, for example, by taking the recommended vaccinations and by trying to prevent traveller’s diarrhoea through good hand hygiene and by eating only freshly cooked food – and of course by avoiding unnecessary antibiotics in the destination,” says Kantele.

In the case of animals, reducing the prevalence of diseases and promoting the health of animals are the most important tools among solutions to antibiotic resistance.

“When animals are healthier and more resistant, they also feel better. Not having to resort to antibiotics at all is the most responsible option,” says Senior Inspector Saija Kalenius from the Finnish Food Authority.

What can pet owners do?

“Owners should keep their pets’ vaccinations up to date, take good care of them, provide them with healthy conditions and ensure, already when choosing them, that the animals have healthy parents. Breeding increases susceptibility to problems,” Kalenius says.

Sociology is needed as well

According to Academy of Finland Research Fellow Salla Sariola, the global causes of antibiotic use are human.

“Antibiotic consumption is embedded deep within the structures of society,” says Sariola while on a field trip to north-eastern India.

In the region, antibiotics substitute for infrastructure, such as healthcare. For Indians, antibiotics are an easy and inexpensive way to solve ailments. All you have to do is pick up drugs, which are available without prescription, from a nearby kiosk or marketplace.

In India, the problem of antibiotic use is societal, which makes it impossible to solve the problem of antibiotic resistance through medicine alone.

“We need the social sciences to identify, understand and perceive why antibiotics are overused and to find out what we can do to safeguard their future use,” Sariola says.

More information:
Can bacteriophages help fight antibiotic resistance?

One solution to antibiotic resistance is bacteriophages, or phages. These are viruses that kill bacteria.

“Bacteriophages identify their target bacteria and multiply inside the bacterial cell. As they do this, they ‘eat’ the bacterium, killing it as they burst out from within. In phage therapy, a matching bacteriophage is identified for each bacterial strain, as phages are precision drugs,” says Professor Emeritus of Bacteriology Mikael Skurnik in an interview at Think Corner (in Finnish).

Skurnik has long studied bacteriophages. In recent decades, he has focused on establishing a phage therapy laboratory in Finland. Currently, Skurnik’s collection contains roughly 600 different phages.

“Our estimate is that a collection of 2,000 phages would be comprehensive enough,” Skurnik says.

In Russia and Georgia, bacteriophages have been used for treatments for a century already. In contrast, in Western countries phages await official authorisation to be recognised as drugs.

How does antibiotic resistance come about and spread?
  • The worst problems associated with antibiotic resistance emerge when microbes carry out gene transfer, a phenomenon typical to them. If a gene that produces resistance against an antibiotic ends up in a pathogenic microbe, the specific drug no longer affects the pathogen, which gains resistance against the antibiotic.
  • The abundant use of antibiotics is one of the key causes of the spread of antibiotic resistance.
  • Antibiotic resistance is spreading particularly in regions where antibiotic use is high and hygiene poor. Meanwhile, travellers transport resistant bacteria from one country and continent to another, which is why resistance is spreading globally. Like the other Nordic countries, Finland belongs to a region where antibiotic resistance is low.