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Resist the ResistanceAct now. Act how?Strategy to prevent catastropheSurveil. SurvivePolicy for Purpose
Bacterial basics 

Antibiotics have been an essential tool for clinicians for 80 years, but their use is the single

most important factor contributing to antibacterial resistance (ABR).1,2

If resistance persists and antibiotics become ineffective, public health will be significantly

impacted.3 The landmark O’Neill ‘Review on Antimicrobial Resistance' (AMR) puts it plainly: the challenge of resistance will only get worse in the future if we do not act now.4



There are two main types of bacterial infections: Gram-positive and Gram-negative – diagnosed and distinguished based on their outer layers. Gram-negative bacteria are encased by a thin peptidoglycan cell wall, which itself is surrounded by an outer lipopolysaccharide membrane, while Gram-positive bacteria have a single thick peptidoglycan layer.5,6

Differences in the cell wall structure of Gram-negative and Gram-positive bacteria5,6


Infections caused by these bacteria differ, too. Gram-negative infections include certain types of pneumonia, bloodstream infections, wound or surgical site infections, and meningitis in healthcare settings. Gram-positive bacteria are responsible, for example, for skin and lung infections, meningitis, and toxic shock syndrome, and can cause other types of pneumonia too.6–8

Due to their distinctive structure, Gram-negative bacteria are typically more prone to developing resistance, and infections caused by multi-drug resistant strains have recently risen significantly.9

On the other hand, Gram-positive bacteria frequently have high intrinsic resistance to antibiotics. These include some of the most widespread resistant pathogens that create serious clinical challenges.8


Resistance to existing treatments is on the rise, yet developing new antibiotics is harder today than it has ever been. In fact, challenges in discovering and producing novel antibiotics are compounded by decreasing investment by industry and public funders.4

The best way to halt resistance to existing treatments is through collective interventions known as ‘stewardship’, including education, guideline development, audits, and feedback promoting sensible antibiotic use. Strategies like these must be enacted at community, national, and global levels.10,11

Read more about what Pfizer is doing to combat antimicrobial resistance.



In 2017, the WHO (World Health Organization) published its first list of bacteria for which new

antibiotics are urgently needed. The list has helped shape the antibiotic landscape, and become a tool for raising awareness of resistance.12 Bacteria were classified into three tiers based on the risk they pose to public health: critical, high, and medium.

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The WHO bacterial priority pathogens list12

The infections resulting from drug-resistant strains of bacteria are very difficult, and

sometimes impossible, to treat. Novel antibiotics could help in the future, but we can start

making changes today with appropriate prescribing and monitoring of existing treatments.13

Identifying and diagnosing bacterial infections.

TitleExample Text Detection and selection Find out
ABR, antibacterial resistance; AMR, antimicrobial resistance; WHO, World Health Organization.References

Ventola CL. P T 2015;40(4):277–283.

Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States. 2013. Available at: Accessed August 2023.

Access to Medicine Foundation. Antimicrobial resistance benchmark. 2021. Available at: https:// Accessed August 2023.

O’Neill J. Tackling Drug-Resistant Infections Globally: Final report and recommendations the review on antimicrobial

resistance. 2016. Available at: Accessed August 2023.

Silhavy TJ et al. Cold Spring Harb Perspect Biol. 2010;2(5):a000414.

National Institutes of Health. National Library of Medicine. Gram Stain. 2021. Available at: Accessed August 2023.

Centers for Disease Control and Prevention. Gram-negative Bacteria Infections in Healthcare SettingsAvailable at: Accessed August 2023.

Jubeh B et al. Molecules. 2020;25(12):2888.x

Exner M et al. GMS Hyg Infect Control. 2017;v12:Doc05.

World Health Organization. Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae,

Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities. Available at:

publications/i/item/9789241550178. Accessed August 2023.

Hernandez-Santiago V et al. PLoS Med 2019;16(6):e1002825.

World Health Organization. WHO publishes list of bacteria for which new antibiotics are urgently needed. Available at: Accessed August 2023.

Koulenti D et al. Microorganisms 2019;7(8):270.

Bacterial Infections
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