An editorial titled “Confronting Antimicrobial Resistance Together” by Henry Chambers, MD, and Vance Fowler, MD, was published in the November issue of the American Journal of Physiology – Lung Cellular and Molecular Physiology. The article reinforces the theme of World Antimicrobial Awareness Week 2022, “Preventing Antimicrobial Resistance Together,” and emphasizes the importance of One Health, a unified, transdisciplinary approach that aims to improve health outcomes by recognizing the interconnectivity of humans, animals, and our shared environments.

Drs. Chambers and Fowler use the COVID-19 pandemic as a key example of the need for a One Health approach to antimicrobial resistance (AMR). In 2020, COVID-19 deaths surpassed the number of deaths caused by the “Big Three” infectious diseases: tuberculosis (TB), HIV-AIDS, and malaria. The authors discuss how progress in the prevention and treatment of these illnesses was disrupted by the pandemic, and suggest that COVID-19 likely exacerbated AMR. Prescribing of antibiotics to patients without a bacterial infection, increases in hospitalizations, and overwhelmed diagnostic laboratories, among other factors, potentially could lead to increased rates of AMR.

The year before COVID-19 emerged, AMR was associated with 4.95 million deaths worldwide, putting this public health concern on par with TB, HIV, and malaria, and potentially even greater. Both COVID-19 and AMR are systemic, global health problems, and many of the same interventions utilized for COVID-19 and other infectious diseases are also effective in addressing bacterial AMR. For example, vaccines to prevent respiratory illnesses like COVID-19 and the flu can reduce hospitalizations and the over-prescribing of antibiotics to treat viral illnesses.

In addition to the misuse of antibiotics in humans, the article points to agricultural use of antibiotics as an area of particular concern for AMR. Approximately 73% of antimicrobials sold globally are given at low doses to animals used for food, creating an ideal environment for the development of drug-resistant bacteria. Organisms carrying resistance genes could be transferred to humans through food chains, to the environment through animal waste, and to other human pathogens, potentially disrupting fragile ecosystems and harming human health. A One Health approach to preventing AMR is especially important as population growth increases our interactions with other humans and animals.

Read the article in the American Journal of Physiology – Lung Cellular and Molecular Physiology.