Antimicrobial resistance: where are we now?

Abstract

Summary: This article discusses the global importance and multifactorial nature of the growing antimicrobial resistance (AMR) threat. It outlines how resistance arises at the level of the bacterium; including intrinsic and acquired resistance mechanisms. It also assesses current approaches to tackling AMR, both in the UK and worldwide, such as: drug development, calls for changes to medical, industrial and legislative practices, and antimicrobial-stewardship. Relevance: With increasing numbers of multidrug resistant organisms causing infections worldwide, medical students must enter the workforce equipped with an understanding of the severity and origins of this situation as well as an appreciation of the steps being taken, and which they themselves can take as future clinicians, to address this challenge. Take home messages: AMR is a multifactorial and continually evolving threat with its origins in the inherent genetic properties of microbes and their evolutionary nature. Consequentially, whilst urgent action is needed to combat an AMR problem exacerbated in recent decades, AMR will always persist. As microbes continually evolve new survival strategies, it is essential to continue to develop new pharmacological agents in conjunction with new practices and policies on institutional, national and international scales to protect global public health from the threat posed by AMR.