A University of Bath-led study reveals that reducing antibiotic prescriptions isn’t sufficient to fight antimicrobial resistance. The research highlights the need for multi-faceted strategies to address the growing threat of “superbugs.”
Antimicrobial resistance continues to pose a grave threat to global health, despite efforts to reduce antibiotic prescriptions, according to a new study led by the University of Bath.
Antimicrobial resistance (AMR) occurs when bacteria evolve and no longer respond to antibiotics, leading to harder-to-treat infections. The World Health Organization ranks it among the world’s top health threats, linked to over 5 million deaths annually.
Researchers from the university’s Department of Chemistry, Centre of Excellence in Water-Based Early-Warning Systems for Health Protection (CWBE), and Institute of Sustainability and Climate Change teamed up with Wessex Water to analyze the presence of antibiotic-resistant genes in the environment through wastewater surveillance.
Their findings, published in the Journal of Global Antimicrobial Resistance, reveal that merely cutting back on antibiotic prescriptions fails to significantly diminish the presence of resistance genes in the environment.
“The spread of antimicrobial resistance is a huge threat to all our lives – we rely on antibiotics for treating common infections and to safely carry out surgical procedures,” corresponding author Barbara Kasprzyk-Hordern, a professor of chemistry and the director of CWBE, said in a news release. “The main focus globally on combatting AMR has been to reduce the amount of antibiotics used, but our research findings show that this alone might not be enough to tackle the problem.”
Over two years during the COVID-19 pandemic, the team analyzed wastewater samples from four treatment plants in southwest England.
They compared levels of antibiotics and AMR genes in these samples with data from before 2019 and examined national prescription records.
Surprisingly, despite a general decline in antibiotic prescriptions from 2017 to 2019, and lower antibiotic levels in wastewater, the presence of AMR genes did not decrease.
It was only during the COVID-19 lockdowns, when social distancing curtailed the spread of resistant bacteria, that reductions in both antibiotic levels and AMR genes were observed. Post-lockdown, both metrics rose again.
“This is really worrying because we had previously assumed that less usage would result in less AMR, but our results show the problem is more complex than that,” added Kasprzyk-Hordern.
The research underscores the need for a ‘One Health’ approach, addressing AMR from multiple angles, including human, animal and environmental health policies.
The researchers plan to continue their crucial work alongside partners from academia, government and industry.
“Our work shows that wastewater-based epidemiology is an innovative and cost-effective monitoring tool that can be used to understand antibiotics usage and how antibiotic-resistant genes spread,” added first author Like Xu. “Through wastewater analysis, this approach helps identify new resistance patterns, understand their transmission, and establish baselines at community level.”
Source: University of Bath