World Pneumonia Day 2024—Fighting pneumonia, antibiotic resistance and pollution

While preparing for World Pneumonia Day 2024, I learned of a relatively new term called antibiotic pollution. Pneumonia of different types impacts on people of all ages, from all walks of life. More pneumonia means more use of antibiotics, leading to the increasing emergence of antimicrobial resistance. Antibiotics or their residues are leaking into the environment. Fluoroquinolones, macrolides, tetracyclines, and sulphonamides have increasingly been reported to be found as environmental contaminants across different parts of the globe. Overuse or inappropriate use of antibiotics does not only apply to humans, with some antibiotics also used in agriculture for some plant and animal farming, leading to the phenomenon of antibiotic pollution. Antibiotic pollution contributes significantly to the development of antimicrobial resistance. This is particularly problematic in a lot of low-to-middle income countries when the economy relies significantly on agriculture. There is increasing worry that antibiotic pollution leading to antibiotic resistance may eventually turn into a racial or ethnic equity issue, in that it may be showing a trend of increasing prominence in impoverished regions. The adverse effects of antibiotic pollution are not less than those of air, water or other forms of pollution, and will ultimately impact humans. There is an increasing prevalence of certain resistant organisms in different parts of the world. In the Asia Pacific regions, methicillin-resistant Staphylococcus aureus, macrolide-resistant Streptococcus pneumoniae, and multidrug-resistant enteric pathogens are becoming prominent with emergence of drug-resistant gram-negative bacilli in Asia. This often results in the vicious cycle of having limited therapeutic choices and high costs of newer antibiotics for these pathogens, resulting in the inappropriate or prolonged use of less effective antibiotics, ending up in suboptimal clinical outcomes. This interplay of antibiotic pollution and antimicrobial resistance is becoming a public health concern. The fight against pneumonia and hence antimicrobial resistance and antibiotic pollution calls for prevention, research and education. This calls for government strategies and initiatives to boost and cultivate public awareness to give concerted efforts to address this regional and cross regional health issue. Development and appropriate implementation of relevant vaccinations to the appropriate group of people would mean reduced use of antibiotics. More research in this field is imminently needed to develop better vaccines and vaccination programs, to develop better and more effective antibiotics with lesser likelihood of drug resistance and spillover into our environment or relevant bio-ecosystems. Public and professional education in this regard could be easier said than done, but still has to be done in an appropriate and timely way. It is vital that more people and health care professionals are aware of the issues of antimicrobial resistance and antibiotic pollution from inappropriate antibiotic usage. None declared.