Sams-Dodd Jeanette, Sams-Dodd Frank
Willingsford Ltd., Southampton, United Kingdom.
Front Public Health. 2025 Jul 15;13:1644086. doi: 10.3389/fpubh.2025.1644086. eCollection 2025.
Since 1954, studies have consistently demonstrated that antimicrobials disrupt microbial environments, causing ecosystem degradation and release of greenhouse gases (GHG), making antimicrobials noteworthy climate stressors. Microbes created an atmosphere on Earth that supports eukaryotic life-forms and are essential for our normal physiological functions. However, despite their critical importance, microbes are mostly associated with infectious diseases, and antimicrobials are extensively used to eradicate them. In healthcare and veterinary medicine, antimicrobials are essential in fighting infections. The general risk associated with their use has focused on antimicrobial resistance and loss of efficacy, whereas their impact on microbial environments and GHGs has been overlooked. Using recent data, a single course of antibiotics is estimated to cause the release of 9.84 tonnes of CO-the equivalent of a standard car driving around the Earth 1.47 times. Given the number of chemicals with antimicrobial effects, such an amount demands attention. Antibiotics, antiseptics, disinfectants, surfactants as well as pesticides, herbicides and many food additives all contribute to antimicrobial-resistance. Despite a focus on antibiotic stewardship, antimicrobials are still used indiscriminately, including where they fail to confer a critical or even demonstrable benefit. Using a One-Health approach, this manuscript provides a non-specialist introduction to the microbial environment and the impact of antimicrobials, and suggests how to minimise the environmental impact of healthcare whilst retaining quality care. Climate change is assumed to contribute to AMR, but this analysis finds that AMR strongly contributes to climate change, i.e., the reverse of the normal assumption. The current climate debate almost exclusively focuses on fossil fuel without in earnest considering other sources. However, without including the major, natural systems that significantly impact the climate, balanced informed decisions to mitigate the situation are impossible to make. By forcing the focus of the climate discussion onto only a narrow, limited set of explanations, the proposed solutions will likely not solve the main causes and their impact is therefore bound to be minimal. This is comparable to symptomatic versus curative treatment in healthcare. Whereas symptomatic treatment can help alleviate, it does not address the root cause and, therefore, cannot restore the patient to health.
自1954年以来，研究一直表明，抗菌药物会破坏微生物环境，导致生态系统退化和温室气体（GHG）排放，使抗菌药物成为值得关注的气候压力源。微生物在地球上创造了一种支持真核生物生命形式的大气环境，对我们的正常生理功能至关重要。然而，尽管它们至关重要，但微生物大多与传染病相关，而抗菌药物被广泛用于消灭它们。在医疗保健和兽医学中，抗菌药物对于对抗感染至关重要。与其使用相关的一般风险主要集中在抗菌药物耐药性和疗效丧失上，而它们对微生物环境和温室气体的影响却被忽视了。根据最近的数据，一个疗程的抗生素估计会导致9.84吨二氧化碳的排放——相当于一辆标准汽车绕地球行驶1.47次。考虑到具有抗菌作用的化学物质数量众多，这一排放量值得关注。抗生素、防腐剂、消毒剂、表面活性剂以及杀虫剂、除草剂和许多食品添加剂都会导致抗菌药物耐药性。尽管人们关注抗生素管理，但抗菌药物仍被滥用，包括在它们无法带来关键甚至明显益处的情况下。本文采用“同一健康”方法，为微生物环境以及抗菌药物的影响提供了非专业人士的介绍，并提出了在保持优质医疗服务的同时如何尽量减少医疗保健对环境影响的建议。人们认为气候变化会导致抗菌药物耐药性，但本分析发现，抗菌药物耐药性对气候变化有很大影响，即与通常的假设相反。当前的气候辩论几乎完全集中在化石燃料上，而没有认真考虑其他来源。然而，如果不考虑对气候有重大影响的主要自然系统，就不可能做出平衡的明智决策来缓解这种情况。通过将气候讨论的重点仅局限于狭隘、有限的一组解释，所提出的解决方案可能无法解决主要原因，因此其影响必然很小。这类似于医疗保健中的对症治疗与根治治疗。对症治疗可以帮助缓解症状，但不能解决根本原因，因此无法使患者恢复健康。
