Yesterday, I received news about antimicrobial resistance (AMR) from our staff at the headquarters in Japan. The message said, ‘The Cabinet  Secretariat has placed a government advertisement in this morning’s Nikkei newspaper about antimicrobial resistance. This is the first time  I’ve seen an advertisement directly appealing to the general public (though there may have been similar ads before).  Does this mean that such a time has arrived?’ When I opened the linked government public relations page, I saw a very basic explanation about antibiotics.  Reading it, I couldn’t help but feel frustrated. What are they saying now, after all this time?  This is something that should have been taught as part of basic education from elementary school, and should be common knowledge for everyone.  It’s not just a responsibility but a duty of the citizens to understand this issue. What has the government  been doing about this problem until now? The phrase “I’m at a loss for words” really fits here.

Furthermore, it’s already too late to address this issue, and current medicine, particularly in the field of infectious diseases, is at a complete  standstill due to how delayed our response has been. There was a time when humanity believed that the invention of antibiotics had conquered infectious diseases, especially after the discovery of  penicillin. However, it eventually became clear that this belief was misguided. The mechanism of action for penicillin (specifically its bactericidal  and bacteriostatic properties) works as follows: Many bacteria survive by maintaining internal pressure with the help of a tough shell called the cell wall. An essential enzyme is needed to construct this cell wall, which must be strong enough to withstand the internal pressure of the cell.

The cell wall is made up of a mesh-like structure, where polymers of two alternating amino acids, called peptidoglycans, are linked together by peptide chains. The enzyme responsible for creating this mesh is known as a cross-linking enzyme. Penicillin mimics the  structure of this enzyme so well that the bacteria attempt to use it in place of the cross-linking enzyme. However, since penicillin is not the  same as the real enzyme, the bacteria fail to form a proper cell wall.  As a result, they are unable to maintain internal pressure, leading to a phenomenon called lysis, which ultimately causes their death. The above  describes the mechanism of β-lactam antibiotics, represented by penicillin, which target bacteria with cell walls. In addition, there are  various other mechanisms of action for antibiotics and antibacterial agents depending on the type of bacteria.