The Question

What are the best strategies for conserving the natural resource of antibiotic effectiveness?

What we found

Global antibiotic use has increased significantly in the last decade, and with this growth has come increased antibiotic resistance. Rather than viewing antibiotic effectiveness as a commodity to be used up, we should approach effectiveness as a resource to be conserved. In this approach, we can utilize strategies from the oil and energy fields, including conservation and innovation. However, it’s important to remember that when conservation efforts succeed, innovation is rendered less necessary, and vice-versa. Because of this, we should strive for successes in both approaches in a balanced way.

To conserve, it is important to both reduce the need for antibiotics and decrease their unnecessary overuse. To accomplish the first, we can improve sanitation and public health, invest in new vaccines and vaccination campaigns, and decrease hospital infection rates. For the second, we can restrict access to newer therapies, focus on public education campaigns, and incentivize clinicians to prescribe fewer antibiotics.

On the innovation side, new antibiotics are rare and oftentimes newly-approved options are far costlier than older classes. Research priorities should include strategies for optimizing current antibiotic use as well as finding new drugs and potential combination therapies. In addition, effective innovations will involve methods for reducing the cost of new antibiotics on consumers, who have few incentives to conserve.

Antibiotic resistance is driven both by a lack of innovation and missing incentives for conservation. An effective strategy for maintaining antibiotic effectiveness will balance both of these approaches, and prioritize the value of antibiotic effectiveness as a natural resource.

Why it matters

Antibiotic effectiveness has been an invaluable tool for public health in the last 70 years, and is one that we risk losing as resistance grows alongside increased use. In order to keep this valuable resource, we need new strategies that consider antibiotics not just as a commodity to be used but as a natural resource to be conserved. We must use conservation and innovation as balanced approaches to preserve antibiotic effectiveness.