Antibiotic resistance poses a growing risk during pandemics

Researchers investigating the drug prescription response to a "superbug" enzyme that renders bacteria resistant to antibiotics are available to discuss why such resistance is posing a growing risk during pandemics such as the current coronavirus.

Manuel Hermosilla, a professor at the Johns Hopkins Carey School of Business, and Chirantan Chatterjee, professor at the Indian Institute of Management Ahmedabad, are studying whether India – ground zero for one of the most dangerous superbugs known as NDM-1 – has reduced its high levels of antibiotic use.

India has one of the world's highest levels of antibiotic resistance due to over-prescribing by medical professionals, excessive consumption of over-the-counter versions, and an abundance of the drugs used in chickens and other animal food products.

"According to the World Health Organization, one of the biggest threats to global health is the growing number of infections – including pneumonia and tuberculosis – that are becoming harder to treat because of antibiotic resistance," Hermosilla and Chatterjee wrote in a summary of their proposed efforts, which recently won a grant from the JHU Alliance for a Healthier World. "India is at the center of the crisis due to the high levels of antibiotic resistance among its population, but also because it was the first country in which the NDM-1 'superbug' was identified."

A World Bank report called Pandemics: Risks, Impacts, Mitigation says antibiotic resistance is a threat that "could amplify mortality during pandemics of bacterial diseases such as tuberculosis and cholera and even viral diseases (especially for influenza, in which a significant proportion of deaths is often the result of bacterial pneumonia coinfections)."

The NDM-1 (New Delhi metallo-beta-lactamase 1) has been detected in 70 countries and "has been touted as a 'doomsday scenario of a world without antibiotics' by public health experts," Hermosilla's summary states.

To counter the growth of antibiotic resistance, nations should be working with their health sectors to reduce the use of the strongest, last-resort antibiotics in order to preserve their effectiveness.

If Hermosilla and Chatterjee find that India has not slowed excessive use of such antibiotics, they aim to develop and recommend "robust policy interventions."

"Antibiotic resistance can lead to longer hospital stays, higher medical costs, and increased mortality," their summary states. Resistance is highest in poorer nations that can least afford such demands.

The issue has been a worldwide concern for several years. The World Health Assembly passed the Global Action Plan on Antimicrobial Resistance in 2015. It called on nations to establish national plans to address antibiotic consumption and resistance, in part, by "optimizing the use of antibiotics through stewardship and appropriate prescriptions," according to Disease Control Priorities: Major Infectious Diseases, a World Bank report.

The Center for Disease Dynamics, Economics & Policy, which has offices in New Delhi and Washington, D.C., maintains the Drug Resistance Index to track antibiotic resistance. India ranked at the top of the list. "In the highly connected world in which we live, the disparity in efficacy is a threat to global public health as resistant pathogens can rapidly spread between countries," the report states.