Causes of Antibiotic Resistance Surgery Photograph by Alessio Mamo / Médecins Sans Frontières

“We risk falling back into a dark age of healthcare”

Dr Rasheed Fakhri, Orthopaedic Surgeon, MSF Amman, Jordan

Photograph by Alessio Mamo / Médecins Sans Frontières
Causes of Antibiotic Resistance Surgery Photograph by Alessio Mamo / Médecins Sans Frontières

What happens when drugs stop working?

Bacteria, viruses, parasites and other microbes are always changing to ensure their survival. Some have adapted so well to medical treatment that drugs commonly used to prevent or kill them are no longer effective.

These microbes cause drug-resistant infections. Their ability to survive medicines used against them is called antimicrobial resistance (AMR). In the case of bacterial pathogens, for which antibiotics are the most common and important drugs available for treatment, we speak of antibiotic resistance (ABR).

“More and more antibiotics are needed,” says Dr Fakhri, “and many patients cannot be treated with the normal range of antibiotics.”

At MSF’s reconstructive surgical program in Amman, Jordan, Dr Rasheed Fakhri treats people injured in the region’s conflicts.

Many arrived after ten or more operations and multiple courses of antibiotics.

Antibiotics are designed to kill bacteria. But if they aren’t prescribed accurately or used correctly, the bacteria can adapt to them.

Then the usual drugs don’t work. So, we have to switch to more powerful medicines which can have a greater risk of toxicity and other side effects, and are often more expensive.

Three things to know about drug-resistant infections

MSF takes on antibiotic resistance

Doctors Without Borders/Médecins Sans Frontières (MSF) Infectious Diseases Adviser Rupa Kanapathipillai answers questions about how MSF sees the global threat of antibiotic resistance at its projects around the world.

What does antibiotic resistance look like in MSF’s field projects?

I’ll give you an example. MSF runs a reconstructive surgical program in Amman, Jordan, for patients from neighboring countries—Iraq, Syria, and Yemen. They’ve often had multiple surgeries and have received courses of various antibiotics before coming to us.

There was a 22-year-old Iraqi patient with a conflict-related injury who had developed an infection of the bone in his lower leg. After surgery, we had some of the tissue from his leg sampled and sent to the lab and we found that he had grown a multi-drug resistant bacteria and it proved to be very, very difficult to treat. We reached the point where he was facing amputation of his leg in order to control the infection. Ultimately, we ended up using Colistin, which is one of the last-line antibiotics available, to treat his infection.

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What MSF staff are saying