Why antibiotic resistance is so low in Sweden

In the war between antibiotics and bacteria, bacteria often seems to be winning … but not in places like Sweden and Denmark.

Antibiotics are a wonder drug, no doubt; but like most miracles they require moderation, and we’ve had a hard time doing that. We often call on them for tasks they're not able to perform. Antibiotics fight bacteria, but here in the United States 36 percent of people surveyed in 2012 wrongly replied that antibiotics can fight a cold virus; 41 percent of them had heard little or nothing about antibiotic resistance.

Along with employing them for all that ails, we also use a prodigious amount of antibiotics in animal feed to promote growth and to prevent disease in the squalid conditions that much of our poultry and livestock are raised in. And as our use of antibiotics increases, wily bacteria evolve to resist them – infections that were once treatable become harder and harder to cure. Bacteria evolves quickly, acquiring resistance to new drugs faster than science can make them.

Our attack on bacteria with a deluge of antibiotics is basically just like boot camp for the bugs. We just make them stronger and stronger.

I’ve always said – kind of joking, kind of not – that one day, bacteria will rule the world if we’re not careful, and a new report shows just where clever bacteria is taking hold. The study maps antibiotic use in 69 countries and antibiotic resistance in 39 countries and reveals some horror-movie worthy data. E. coli is proving resistant to a number of drugs in many places across the globe. In India, E. coli is resistant to almost every drug known to treat it; strains of E. coli tested there were more than 80 percent resistant to three classes of drugs, and treatment options are fading.

"What this report makes clear is that even though antibiotic consumption in the developing world is not yet at the same level as the developed world, resistance is getting to be very high," says one of the report’s authors, Dr. Ramanan Laxminarayan. "Resistance is a problem everywhere. It's truly a global problem and requires an urgent response."

But some countries, like those in Scandinavia, are remarkable in their low rates of antibiotic resistance. Sweden and Denmark have virtually none; how is this possible?

It’s simple. Citizens in these countries are educated about the dangers of antibiotic overuse. Brilliant, right? So, for example, it would be highly unusual for a Swede or a Dane to go to the doctor and request antibiotics. "It's a question of social norms," says Laxminarayan.

And it provides a potent model for what the rest of the world should be doing. People from country to country need to be educated on this – and physicians and hospitals need to become more diligent – to diminish the rates of inappropriate antibiotic use across the planet.

"In the absence of antibiotics, resistant bacteria more easily die out," Laxminarayan says. "In many cases, if we stop overusing antibiotics, resistance will go substantially down."

"There's a long way to go, a lot of work to be done," says Laxminarayan, "but if we lose antibiotics, there really isn't very much else." As in, prepare to meet your new bacteria overlords?


Tags: Antibiotics | Diseases | Medicine | Scandinavia | Sweden


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