If you’ve ever had a sinus infection, strep throat, or ear infection, you’ve most likely taken antibiotics to halt and kill bacteria growth. While antibiotic drugs are normally effective, germs have discovered ways to outsmart the medications they’re exposed to. This phenomenon is known as antimicrobial resistance.
“Bacteria can either modify the drug to make it ineffective, export the drug really fast from the cell so it doesn't have time to do its job, or make modifications to cell structure,” says Bryant’s Biological and Biomedical Sciences Professor Christopher Reid, Ph.D.
He adds that the last big push for the creation of groundbreaking antibiotics occurred between the 1950s and 1970s, and that the decline in developing revolutionary drugs has to do with the funding model for this line of work.
“Pharmaceuticals are financially disincentivized from creating new antibiotics because resistance to a drug builds up relatively quickly. For a pharmaceutical company to spend all that money to develop an antibiotic, you're most likely not going to see the lifetime of the patent before significant resistance crops up,” says Reid, noting that after Penicillin was made available, the first report of resistance came around the same time. He adds that, today, companies often choose to modify existing antibiotics.
Over the last 20 years, resistance to antibiotics has increased at alarming rates — prompting the Centers for Disease Control and Prevention (CDC) to flag the issue as a national public health priority. More than 2.8 million Americans experience antimicrobial-resistant infections annually and approximately 35,000 die each year, according to the CDC. While antimicrobial resistance can impact all individuals, women are disproportionately affected.
Increased vulnerability
Biological, social, cultural, and economic factors increase women’s risk of acquiring infections, including drug-resistant ones.
“There has been a high rate of antimicrobial-resistant organisms — mostly associated with urinary tract infections — among pregnant women in developing countries; however, this trend is also present in several developed nations,” Reid says.
In many areas, resistance to third generation cephalosporins (antibiotics used to treat things like meningitis, UTIs, respiratory tract infections) is common; this makes treatment with an ineffective antibiotic highly likely, which further exacerbates the problem. Reid notes that, if left untreated, the issue can lead to severe complications that can seriously affect the woman and fetus.
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Reid explains that different genders have different health-seeking behaviors that influence their likelihood of having access to, and appropriately using and administering, antimicrobials. Socio-economic status is one factor that reduces access to healthcare; demographics is another, with immigrant and rural populations reporting decreased access.
Additionally, the careers women take on can increase their susceptibility. Many women are frontline workers in the healthcare industry and caregivers — with the World Health Organization reporting that women make up 70 percent of the global health workforce.
“These settings place them at increased risk of encountering individuals with antimicrobial-resistant infections and, in turn, a higher risk of contracting an antimicrobial resistant infection,” Reid says.
Combating the problem
According to the WHO, women are 27 percent more likely to receive antibiotics throughout their lifetime than men. In late 2024, the organization put forth recommendations on how member states can implement gender analysis into antimicrobial resistance research. Recommendations include awareness campaigns for vulnerable groups, prescription audits, and identifying unconscious gender biases or inequalities in prescribing practices.
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Scientists, Reid adds, are also working on making ineffective antibiotics effective again. This can be accomplished by either taking an old antibiotic and pairing it with another drug that helps resensitize the bacteria to that once-resistant drug or developing strategies to circumvent the resistant mechanisms. At Bryant, Reid has his own microbial glycoscience lab where he works to develop antibacterial and antifungal compounds; his focus is on masarimycin, a chemical compound developed in the Reid Lab that exhibits promising antibacterial applications.
“There is a search for new targets in bacteria, so things that haven't previously been exploited could serve as a new treatment strategy,” Reid says. “Many of our most successful antibiotics target how bacteria assemble its cell wall. So even looking at classic strategies like targeting the bacterial cell wall but finding a previously untapped target to develop a drug for.”
