"When antibiotics were first introduced, it was inconceivable that we would eventually confront the significant issue of antibiotic resistance faced today. The adaptive capacity and rapid evolutionary potential of bacteria were greatly underestimated."

Bonnie Bassler

Since 2015, under the initiative of the World Health Organization (WHO), World Antibiotic Awareness Week has been observed annually from November 18 to 24. This campaign aims to educate the public on the proper use of antibacterial medications to prevent complications and promote responsible antibiotic use.

The primary objective of this global initiative is to raise awareness about the growing threat of antibiotic resistance and to encourage the adoption of advanced strategies to curb its progression and dissemination.

Antibiotics are substances of natural or synthetic origin that either destroy microorganisms or inhibit their ability to reproduce. In 1929, the English microbiologist Alexander Fleming discovered the first antibiotic, penicillin, marking a landmark achievement in science. This discovery catalyzed a transformative era in biology and medicine, often referred to as the "antibiotic era." From the 1940s onward, antibiotics became an integral component of medical practice, revolutionizing the treatment of infectious diseases that were once considered fatal. Initially, antibiotics were hailed as a panacea due to their remarkable effectiveness against life-threatening infections.

Currently, there are over fifteen distinct classes of antibiotics, encompassing agents with not only antibacterial properties but also antifungal and antitumor activities. This wide variety and broad spectrum of action significantly enhance the ability to combat infections. However, this progress has led to a critical challenge—bacterial resistance to antibiotics, commonly referred to as "antibiotic resistance," "antimicrobial resistance," or "drug resistance."

Antibiotic resistance arises through mutations in microorganisms that enable them to withstand the effects of previously effective drugs. As a result, an increasing number of infectious diseases are becoming more challenging to treat due to the diminishing efficacy of antibiotics. This resistance leads to prolonged hospital stays, higher medical expenses, and increased mortality rates.

A significant contributor to this issue is the misuse of antibiotics, including their unnecessary administration, inadequate treatment duration, insufficient dosages, and, most critically, their use against diseases for which they are ineffective.

In 2017, international experts estimated that antimicrobial resistance (AMR) accounted for approximately 700,000 deaths globally each year. By 2019, coinciding with the onset of the COVID-19 pandemic, this number had risen to 1.2 million recorded cases. Projections indicate that AMR-related deaths could reach 10 million annually by 2050, a figure that may continue to escalate. The emergence of antibiotic resistance has significantly complicated the treatment of severe bacterial infections, including pneumonia, gonorrhea, salmonellosis, tuberculosis, and others.

The development of new antibiotics presents a formidable challenge. The complete drug development cycle, from discovery to market introduction, spans over a decade and incurs costs estimated at 200–300 billion rubles. Alarmingly, bacterial resistance to newly developed antibiotics typically emerges within an average of one year after their introduction. Consequently, minimizing the overuse and misuse of antibiotics is critical in slowing the progression of resistance.

Each individual bears a responsibility to safeguard their health and adhere to a few fundamental principles to combat antibiotic resistance effectively. To prevent the rise of AMR, the following measures are essential:

·       Antibiotics should be used only when strictly indicated, and exclusively after a doctor has confirmed the presence of an infectious disease.

·       Avoid unnecessary use of antibiotics, including for prophylactic purposes, unless explicitly prescribed.

·       Administer antibiotics in the correct dosage and for the prescribed duration, even if symptoms improve before completing the course.

·       Refrain from recommending or sharing medications with relatives or friends.

·       Strengthen your immune system by maintaining a balanced diet, engaging in regular physical activity, and adhering to proper hygiene practices.

·       Recognize that doctors often prescribe probiotics alongside antibiotics to support gastrointestinal health. Ignoring this recommendation can disrupt the intestinal microflora, potentially weakening the immune system.

·       Utilize preventive measures, such as vaccinations, to reduce the risk of illness.

"The more we study drug resistance, the greater our concern becomes. It fundamentally indicates that we are approaching the limits of antibiotic efficacy."

Tom Frieden

Department of propaedeutics of children’s diseases

translated by Ismoilov R.