Antimicrobial resistance necessitates public debate

Antibiotics are drugs that support the immune system of the patient to overcome an infection. The availability of antibiotics, in the middle of the last century, has had significant, positive effects for the treatment of some infections, but not all: after all, the course of viral infections is not affected. Intensive and often improper use of antibiotics, however, has led to resistance to the effect of bacteria. Because of excessive use of antimicrobial agents and the presence of vulnerable people, (multi) resistant microorganisms are particularly present in hospitals and nursing homes. But the problem is no longer limited to a single hospital or a single healthcare facility. The threat caused by antimicrobial resistance is increasing. It may be that severe measures need to be taken to prevent the rise of morbidity and mortality of future – now treatable – infections. Some measures can be profound and raise ethical questions. That calls for a discussion on the proportionality of measures that possibly should be taken in the future.

This Spectrum is a contribution to this debate. First, van der Lubben and colleagues present a brief overview of the current state of affairs. Subsequently, responses from different perspectives (clinic, health care facility, infectious disease protection, animal husbandry, inspection) are given. Those responses make clear that this debate is needed, to get a view on ethical dilemmas and situations in which the interests of patients may seem inconsistent with the public interest in the short term and that of patients in the long term.