Superbugs on the rise: A veterinarian’s take on the AMR crisis
The discovery of antibiotics revolutionized modern medicine, saving millions of lives. In 1928, Alexander Fleming discovered penicillin, the first widely used antibiotic, which marked the beginning of an era where bacterial infections became treatable. This breakthrough led to the development of various classes of antibiotics, significantly reducing mortality from bacterial diseases. However, even at the dawn of this discovery, Fleming foresaw a potential issue. In his 1945 Nobel Prize speech, he warned:
“But I would like to sound one note of warning. It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body. There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.”
His words were prophetic. Today, antimicrobial resistance (AMR) is a major global health crisis, and we are witnessing the rise of so-called ‘superbugs’—bacteria that no longer respond to antibiotics. As microorganisms such as bacteria, viruses, fungi, and parasites evolve to resist the effects of drugs that once effectively treated infections, standard treatments become ineffective, allowing diseases to persist and spread. This growing resistance is driven by a combination of factors, including the overuse of antibiotics in human medicine, excessive use in animal agriculture, poor infection control, and environmental contamination.
The emergence of superbugs has made treating infections increasingly difficult. Bacteria like methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Mycobacterium tuberculosis (MDR-TB), and carbapenem-resistant Enterobacteriaceae (CRE) are causing longer illnesses, higher treatment costs, and increased mortality. The implications are alarming—routine surgeries, chemotherapy, and organ transplants rely on effective antibiotics, and the rise of resistant bacteria threatens the success of these procedures. The World Health Organization estimates that by 2050, AMR could lead to 10m deaths annually if urgent action is not taken. The economic burden is equally severe, with prolonged hospital stays and expensive alternative treatments straining healthcare systems. In agriculture, AMR reduces livestock productivity and increases foodborne illnesses, putting global food security at risk.
For decades, antibiotics were widely used in livestock not only for treating diseases but also for growth promotion. This practice allowed farmers to raise larger, faster-growing animals, meeting the demands of a growing population. However, the excessive use of antibiotics in animal agriculture contributed to the spread of resistance. In response, many countries have now banned or strictly regulated the use of antibiotics for growth promotion, encouraging alternatives such as probiotics and improved animal husbandry. Despite these efforts, antibiotic residues continue to pose a risk, as they persist in milk, meat, and eggs, potentially exposing consumers to low doses of antibiotics that further drive resistance. The issue extends beyond just the farm. When these residues enter the food chain, they create an environment where bacteria are constantly exposed to sublethal doses of antibiotics, increasing the chances of resistance developing and spreading.
Beyond hospitals and farms, antibiotic residues have seeped into the environment, creating an overlooked but serious AMR hotspot. Wastewater from hospitals, pharmaceutical industries, and livestock farms often carries antibiotic residues into rivers and other water bodies. These contaminated environments serve as breeding grounds for resistant bacteria, increasing the likelihood of AMR spreading through water sources, wildlife, and agricultural ecosystems. The presence of antibiotics in rivers not only affects aquatic organisms but also contributes to resistance genes being transferred between bacteria, making it even harder to control the spread. This environmental contamination, often ignored in AMR discussions, is a significant driver of resistance, highlighting why tackling this issue requires a broader approach.
As a veterinarian, I have seen the consequences of AMR in animal health and food production. Infected animals that once responded to treatment now require stronger antibiotics or do not recover at all. This affects both small-scale farmers and large industries, reducing productivity and increasing costs. The economic loss is particularly severe in low-income countries where access to effective antibiotics is already limited. In such regions, resistant infections in animals mean longer illness periods, decreased milk or meat production, and greater financial strain on farmers who depend on livestock for their livelihoods. The risk is not limited to agriculture—AMR in animals can directly impact humans. Resistant bacteria can transfer from animals to people through direct contact, consumption of contaminated food, or even through environmental exposure, making AMR a shared concern for human and animal health alike.
AMR cannot be solved by just focusing on human health and human antibiotic control—addressing its spread in animals and the environment is equally critical. The One Health approach recognizes that human, animal, and environmental health are deeply linked, and addressing AMR requires coordinated efforts across multiple sectors. Responsible antibiotic use in healthcare, stricter regulations in livestock production, improved wastewater management, and sustainable agricultural practices must all be part of the solution. Veterinarians play a key role in this effort, ensuring that antibiotics are used responsibly in animals, educating farmers about alternative disease prevention strategies, and advocating for policies that reduce unnecessary antibiotic use.
Despite the challenges, there is hope. Many countries, including Nepal, have implemented national action plans to combat AMR, focusing on surveillance, regulation, and public awareness. Research into alternative treatments, such as phage therapy and antimicrobial peptides, is progressing, offering potential new solutions. Farmers and veterinarians are increasingly adopting better husbandry practices, including improved hygiene, vaccination programs, and nutritional management, reducing the need for antibiotics in the first place. However, change must happen faster. Awareness alone is not enough; coordinated global action is needed to slow down the spread of resistance before we lose one of the most powerful tools in modern medicine.
By taking a One Health approach and working together globally, we can help slow AMR and protect future generations from the looming threat of untreatable infections. The time to act is now, before Fleming’s warning turns into an irreversible reality. If we fail to control AMR, we risk entering a post-antibiotic era where common infections become deadly once again. As a veterinarian, I see the urgency of this issue every day, and I believe that only through a united effort—across human health, animal health, and environmental protection—can we hope to turn the tide against this silent pandemic.
