The evolving response to antibiotic resistance (1945–2018)

Abstract

The intensity and character of concerns about antibiotic resistance, over the past nearly seventy-five years, have depended on a series of linked factors: the evolution and distribution of resistant microbes themselves; our differential capacity and efforts to detect such microbes; evolving models of antibiotic resistance and the related projected impact of antibiotic resistance on medical, social, and economic futures; the linkages of antibiotic prescribing and usage to the prevailing practice and identities of the medical and veterinary professions, and to the practice of agribusiness; the projected capacity of biomedicine (and especially the pharmaceutical industry) to stay ahead of such developing resistance; the perceived global context in which such resistance has developed; and the coordination of efforts and the development of infrastructure and funding to draw attention to and confront such microbial resistance. This paper traces the evolving response to antibiotic resistance through what at this point appear to be five eras: that between 1945 and 1963, a relatively optimistic period during which time the pharmaceutical industry appeared to most as capable of keeping up with antibiotic resistance; that between 1963 and 1981, characterized by increasing concern (though limited reformist activity) in the wake of the discovery of the transmission of antibiotic resistance via extrachromosomal plasmids; that between 1981 and 1992, notable for the explicit framing of antibiotic resistance as a shared global problem by such reformers as Stuart Levy and the Alliance for the Prudent Use of Antibiotics; that from 1992 through 2013, during which time antibiotic resistance became linked to larger concerns regarding emerging infections and received increasing collective attention and funding; and that from 2013 through to the present, with antibiotic resistance still more palpably and publicly embedded within larger concerns over global emerging infections, social justice, and development goals, attracting interest from a diverse cohort of actors.

Veterinarian ‘responsibility’: conflicts of definition and appropriation surrounding the public problem of antimicrobial resistance in France

“…T he problem of antimicrobial resistance (AMR) is particularly interesting because it is highly fragmented between actors competing for its ownership, making it relatively plastic and subject to many controversies with regard to its modalities of regulation (Bud, 2007;Podolsky, 2015Podolsky, , 2018. One specific facet of this problem is particularly affected by these conflicts of definition and appropriation: the agricultural sector.…”

Therapeutic lipid-coated hybrid nanoparticles against bacterial infections

“…Microbial infection is one of the biggest threats to global public health today due to the rapid evolution of antibiotic resistant strains. [1][2][3] Increasingly, multidrug resistant pathogenic strains of bacteria are now routinely isolated from all parts of the world. [4][5][6][7] Pathogenic microorganisms, such as Enterococcus, Staphylococcus and Pseudomonas, are closely related species that are responsible for a wide variety of common bacterial infections.…”

Antimicrobial resistance: preventive approaches to the rescue? Professional expertise and business model of French “industrial” veterinarians

“…As soon as these molecules were introduced in agriculture in the late 1940s, there was controversy concerning the development of resistant bacteria in animals and food, and the risks of human contamination (Bud 2007). Yet for several decades, this issue has been eclipsed by the belief in a permanent renewal of the therapeutic arsenal, consisting in thinking that the continuous discovery of new antibiotics would compensate for the development of increasingly resistant bacteria (Podolsky 2018). After the Swann report in 1969, a series of measures to control the use of antibiotics as growth promoters 1 was nevertheless adopted in Europe, progressively separating the molecules used in agriculture and human medicine (Kirchhelle 2018).…”