The risk/benefit of predicting a post-antibiotic era: Is the alarm working?

• Published in: Annals of the New York Academy of Sciences Vol. 1323; no. 1; pp. 1 - 10
• Main Authors: Fowler, Tom, Walker, David, Davies, Sally C.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-09-2014; Wiley Subscription Services, Inc
• Subjects: Alarm systems; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antiinfectives and antibacterials; Antimicrobial agents; antimicrobial resistance; Bacteria - drug effects; Bacteria - growth & development; Drug resistance; Drug Resistance, Microbial; Governments; Human; Humans; Policies; policy; post-antibiotic era; raising the alarm; Risk; Risk assessment; Security; post-antibiotic era; antimicrobial resistance; raising the alarm; policy
• ISSN: 0077-8923; 1749-6632
• DOI: 10.1111/nyas.12399

There have been concerns about antimicrobial resistance since the first widespread use of antibiotics in humans. More recently, this concern has grown and become the focus of clinical, scientific, and political activity. In part, the political interest is a consequence of publicizing a bleak picture of a post‐antibiotic world. There are, however, dangers in using a discourse of fear. In this article, we discuss whether the evidence base is available to justify such claims and, more importantly, put this in the policy context with which it is used. Many governments now use a risk assessment approach to identify security concerns, based on reasonable worst‐case scenarios. There is no doubt that for effective policy‐based action to occur, antimicrobial resistance needs to be seen as a national and international security priority, particularly as the major cost of inaction will mostly be felt in the future. We conclude that presenting the evidence in a manner that is used to encourage prioritization of security policy is not only justified, it is essential to drive action in this area.