PerspectiveInfectious Disease

A return to the pre-antimicrobial era?

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Science  06 Mar 2015:
Vol. 347, Issue 6226, pp. 1064-1066
DOI: 10.1126/science.aaa2868

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After many years out of the limelight, antimicrobial resistance (AMR) in bacteria is firmly back on the international political and scientific agenda (1, 2). The potential impact of AMR on hospital-acquired bacterial infections such as Staphylococcus aureus and Acinetobacter baumannii in higher-income countries has created both fear and a surge of motivation aimed at providing new solutions for the problem (3, 4). The political will and momentum to tackle AMR lies in higher-income countries, but the medical, social, and economic effects of AMR are likely to be felt more in lower-income countries, particularly those in South and Southeast Asia and in sub-Saharan Africa. The identification and development of new drugs is a potential solution but is challenging and costly; any novel therapies introduced into low-income settings without a suitable infrastructure to understand and prevent the rapid development of resistance will likely be expensive and futile.