Patients are already dying as wonder drugs lose their effectiveness. International action is urgently needed

As apocalyptic horror stories go, it’s up there with the scariest. Yet it’s not fiction writers but top scientists who are warning of how the world could look once superbugs develop resistance to the remaining drugs against them in our hospital pharmacies. Patients will die who can currently be cured; routine surgery will become dangerous or impossible. Antimicrobial resistance (AMR) – it happens not only with bacteria but also viruses, fungi and parasites – is one of the top global public health threats facing humanity, says the World Health Organization (WHO). It kills 1.3 million people and contributes to 5 million deaths every year, predicted to be 10 million by 2050. In addition to the appalling human toll, it will increase the strain on and costs of health services. But is it high enough up the agenda? Covid-19 knocked it off, and the climate crisis gets more attention. AMR does not so often get top billing.

This week efforts have been made to change that, with talks at the UN triggering wider coverage chronicling the sorry plight we are in. From the pharmaceutical industry to the WHO to NHS England, the same tune is being played: we are not doing enough to avert disaster.

Scientists point to loopholes in new legislation that have been closed under European Union regulations

New rules intended to reduce the use of antibiotics in farming in the UK have been criticised as too lax and weaker than their equivalent under EU laws.

The updated regulations come into force on Friday. They ban the routine use of antibiotics on farm animals, and specifically their use to “compensate for poor hygiene, inadequate animal husbandry, or poor farm management practices”.

Enlarge / A dog gets examined by veterinary technicians in Texas. (credit: Getty | Michael Paulsen)

Two separately owned dogs in New Jersey tested positive last year for a dreaded, extensively drug resistant bacterial strain spread in the US by contaminated artificial eye drops manufactured in India. Those drops caused a deadly multi-state outbreak in humans over many months last year, with at least 81 people ultimately infected across 18 states. Fourteen people lost their vision, an additional four had eyeballs surgically removed, and four people died.

The preliminary data on the dogs—presented recently at a conference of disease detectives hosted by the Centers for Disease Control and Prevention—highlights that now that the deadly outbreak strain has been introduced around the US, it has the potential to lurk in unexpected places, spread its drug resistance to fellow bacteria, and cause new infections in people and animals who may have never used the drops.

The two dogs in New Jersey were not known to have received the drops linked to the outbreak: EzriCare Artificial Tears and two additional products made by the same manufacturer, which were recalled in February 2023. Such over-the-counter products are sometimes used in animals as well as people. But the dogs' separate owners said they didn't recall using the drops either. They also didn't report any exposures in health care settings or recent international travel that could explain the infections. One of the dogs did, at one point, receive eye drops, but they were not an outbreak-associated brand. The only connection between the two dogs was that they were both treated at the same veterinary hospital, which didn't stock the outbreak-associated eyedrops.

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