Alternatives to Antibiotics

The antibiotic resistance problem is caused by the evolution and transfer of genes that confer resistance to medically important antibiotics into human pathogens. The acquisition of such resistance genes by pathogens complicates disease treatment, increases health care costs, and increases morbidity and mortality in humans and animals. As antibiotic resistance continues to evolve, antibiotics of so-called last resort become even more precious. Reducing or preventing the dissemination of antibiotic resistance genes into human pathogens is currently of high international importance. First, more than 70 years of antibiotic use have already selected for diverse and highly mobile antibiotic resistance genes in human pathogens and related bacteria. These resistant bacteria spread in the environment via water, air, wildlife, and humans, so targeted mitigation strategies are needed to decrease the environmental dissemination of antibiotic-resistant bacteria from “hot spots” of potential resistance development. Second, highly mobile resistance genes can be horizontally transferred from one bacterium to another. Resistance gene transfer events can be stimulated by antibiotics themselves. Therefore, prudent use of antibiotics is one potential mitigation strategy to slow the spread of resistance genes among bacteria. The use of antibiotic alternatives to promote health and reduce disease will decrease antibiotic use, thereby decreasing selective pressure for the emergence and transmission of antibiotic-resistance genes.

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