Response

Surveillance

     Several surveillance systems collecting data on antibiotic use, bacterial infection incidence, and healthcare-related infection have been established in the past two decades, but many gaps remain.


                          Africa                                    Americas                     Eastern Mediterranean
                          Europe                            South-East Asia                         West Pacific
Proportions of countries with surveillance data available or unavailable on antibiotic-resistant bacteria, by WHO region.4

Trends

     Some public health campaigns have made their mark - antibiotic use has gotten smarter. Antibiotic use in Canada declined 12.5% in per capita prescriptions between 2000 and 2013 [8], with the US National Ambulatory Medical Care Survey (NAMCS) reporting a 13% decline in antimicrobial usage [9]. However there is no significant decline in Europe [10]. This is insufficient.


New Antibiotics

     Only 2 novel antibiotics were discovered between 1998 and 2009, with only 7 in development as of 2013 [4][11]. Pharmaceutical companies see little incentive in antibiotic development, with the cost to bring a new drug to market at around $1 billion. New incentives and strategies need to be brought about to develop new, safe, and broad-range antibiotics to combat adapted bacteria, followed by prudent stewardship. Recent development includes the research of a new class of antibiotics called oxadiazoles, and research on targeting an enzyme present in MRSA . These developments cover gram-positive bacteria such as MRSA, but antibiotics for gram-negative bacteria such as E. coli remain elusive.