Antimicrobial Resistance (AMR)/Antibiotic Resistance

Antibiotic resistant infections, also called antimicrobial resistance, are infections caused by bacteria that don’t respond to traditional antibiotics. It is an increasing problem around the world. Physicians need antibiotics to treat infections that can lead to sepsis, but the drugs can also be overused, causing resistance. According to the World Health Organization (WHO), antibiotic resistance is an increasingly serious threat to global public health.

Sometimes called blood poisoning, sepsis is the body’s life-threatening response to infection or injury. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, and organ dysfunction (organs don’t work properly), and/or amputations.

Discovery of antibiotics

Historians know that people in ancient Rome and earlier used items with antibiotic properties, but Sir Alexander Fleming discovered  the first antibiotic in modern medicine, penicillin, in 1928.  People thought it was a wonder drug. Before penicillin became available, the simplest of infections could result in death. It proved its worth the early 1940s, as the drug saved many soldiers in WWII. However, even back then, Fleming cautioned that doctors use penicillin wisely. He feared that using it for too short a period or using too little of it may make bacteria mutate and become resistant to it. By 1947, his fear already came true. The first penicillin-resistant bacteria appeared.

After penicillin’s discovery, scientists went on to discover several more antibiotics. These included tetracycline (1944), erythromycin (1948), and ciprofloxin (1961), among others.

What antibiotics do

Most bacteria are harmless. They are everywhere, including on our skin, and in our mouth and gut. But some bacteria are harmful if they get inside the body. There, they cause an infection and can lead to sepsis, septic shock, and death if left untreated. For example, before antibiotics, strep throat could be a fatal disease and up to 90% of children who developed bacterial meningitis died.

Antibiotics treat or stop infections in one of two ways: they either kill the bacteria outright or they stop their ability to reproduce, so that they stop spreading and causing further harm. These drugs have no effect on viral or fungal illnesses. There are some anti-viral and anti-fungal drugs though. These drugs, together, are anti-microbial agents or anti-microbial drugs.

Superbugs: How antibiotic resistance became a problem

Not all types of antibiotics can kill all types of bacteria. Researchers continue to look for newer and better antibiotics to try to treat all types of infections. The most commonly known “superbug,” or antibiotic-resistant bacteria is MRSA, methicillin-resistant Staphylococcus aureus, first found in 1961. As the years passed, MRSA became resistant to the most commonly used antibiotics: penicillin, methicillin, tetracycline, and erythromycin. A newer drug, vancomycin, did treat MRSA, but it was expensive and doctors tried to use vancomycin sparingly to reduce the risk of MRSA mutating again. In 2002, researchers detected VRSA – vancomycin-resistant Staphylococcus aureus. Enterococcus, a common cause of urinary tract infections, can be resistant to vancomycin and is called vancomycin resistant Enterococcus or VRE.

The race for new antibiotics continues. But there is a real concern that bacteria will mutate and we won’t have a treatment. It is essential to educate people about the proper use of antibiotics.

Slowing down development of antibiotic resistance

Fleming’s predictions came true. Using too little or too short a course of antibiotics for a specific infection can result in bacteria mutations and resistance. The reverse is also true – people can use antibiotics for too long, resulting in resistance. In addition, using any type of antibiotic inappropriately, such as taking one to treat a viral infection, or not taking a prescription properly, can also cause superbugs to develop. Everyone, from the general public to healthcare professionals have a role to play in reducing antibiotic resistance.

You can help reduce the growth of antibiotic resistance by:

  • Not insisting that your doctor or nurse practitioner give an antibiotic for an illness not caused by bacteria, such as influenza, a cold, or a sore throat (unless it is strep throat.)
  • Never taking an antibiotic prescription not prescribed for you. In other words, don’t take a relative’s or friend’s antibiotic because you think you may have the same infection.
  • Completing your prescription as directed. This includes the right number of times of day, the correct dosage, in the correct way, for the full length of time, regardless of how well you may feel.
  • Practicing infection prevention, by thorough and frequent hand washing, avoiding people who have infections, and getting recommended vaccinations.

The treatment for sepsis is antibiotics and fluids, among other therapies. Sepsis experts worry about antibiotic resistance. They support measures to prevent resistance, because controlling infection with appropriate antibiotics is the cornerstone of sepsis treatment. Without adequate antibiotics to treat patients, the future of sepsis care would be grim. We must slow down the growth of superbugs so that we can successfully continue to treat bacterial infections and save lives of those who have sepsis.

The information here is also available as a Sepsis Information Guide, which is a downloadable format for easier printing.

Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.

Suggested Citation: Sepsis Alliance. Sepsis and Antimicrobial Resistance (AMR)/Antibiotic Resistance. 2022. https://www.sepsis.org/sepsisand/antibiotic-resistance/

Updated November 1, 2021.

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Mary Lansing

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This story is about my mother Mary. She was a healthy dialysis patient. (Sepsis and Invasive Devices) She didn’t want to get an infection so she agreed to have a graft put under her skin which was safer than having a dialysis catheter. She always was careful to follow the doctor’s advice. One night after dialysis, she got up from bed to go to the bathroom. And got dizzy and fell and broke her ankle in many places. When she got to the emergency room, she was found to be septic and that was what caused her to fall. Not ... Read Full Story

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Beauden Baumkirchner

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Beauden born a healthy boy, fell off his bike when he was 3 on the first day of our family vacation in San Diego in October of 2020. He scraped his knee and 48 hours later was admitted to a Pediatric ICU in San Diego where he stayed for 2 months, then another floor for 2 more weeks. Beauden contracted staph which was MSSA but acted like MRSA and went into septic shock. (Sepsis and Antimicrobial Resistance (AMR)/Antibiotic Resistance) He required a bilateral leg amputations and lost a couple fingers as well. (Sepsis and Amputations) To date, he has had ... Read Full Story

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Rebecca Brindle

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Annette S.

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In August 2017, I went for small intestine/ colon surgery and liver resection to remove cancerous tumors. I was a few days post op and doing well. Then I started having shooting pains in the liver area that oral pain med didn’t touch, and then I developed heart rhythm abnormality, atrial fibrillation, which I’d never had before. (Sepsis and Surgery) Being a nurse, I noticed it on the monitor and pointed it out to doctors and nurses. They gave me IV medicine, which eventually did put my heart in rhythm. But I was still having severe pain. The doctors were ... Read Full Story

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Tony Cornias

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I think my story is a little odd myself, but here goes. In the summer of 2003 on a Wednesday afternoon, my brother asked me to drop off work and I agreed. I was on my way back to the office and while crossing the street I felt a twinge of pain in my left leg above my ankle. By the time I made it thru the intersection (60′ or so) I could not bear any weight on my leg. Within the next minute, I made my way to my car and started shaking and was cold as could be; ... Read Full Story

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Antimicrobial Resistance (AMR)/Antibiotic Resistance

Antibiotic resistant infections, also called antimicrobial resistance, are infections caused by bacteria that don’t respond to traditional antibiotics. It is an increasing problem around the world. Physicians need antibiotics to treat infections that can lead to sepsis, but the drugs can also be overused, causing resistance. According to the World Health Organization (WHO), antibiotic resistance is an increasingly serious threat to global public health.