How AI platforms can help us understand ABR and the POSTABR® era

Richard Stead, CEO of The Qures Group, discusses how different AI platforms can help us define different eras of antimicrobial resistance in a growing period of crisis.

I have to admit to now being an admirer of AI. What I had not realised is that the better able and succinct you can be in what you want from AI, the better answer it can deliver. I should not be surprised by that simple conclusion. After all, I have faced the same confused look on people’s faces when I ask an ill-conceived/defined question.

I conceived and registered the word/phrase POSTABR®, meaning what needs to happen to take the world out of the era of antibiotic resistance, that is, the current (existing) period in health/medicine since bacterial pathogens developed resistance to cures and treatments developed by humans. 

Whilst many of the general population know about what is meant by ABR and the B stands for biotic/bacterial, they are only just recognising that many other pathogens (that includes viruses, fungi and parasites) are copying the techniques developed by bacteria to fight the treatments humans are creating. These microbial organisms are sharing their knowledge.

Humans are running out of ideas to destroy pathogenic bacteria and other types of pathogens. To cover the growth in resistance by these other pathogens, the term ABR has been replaced by antimicrobial resistance (AMR) and extended to anti-multi-drug resistance (AMDR) when an organism can resist many (sometimes ALL) the cures humans have created.

Somehow, we must achieve an end to resistance. Somehow, we must find our way out of the ABR/AMR era and into my POSTABR® era.

It is at this point that I made contact with artificial Intelligence (AI) to help me explain what I mean by POSTABR®. Below, you will see how AI helped me and realise the first response was: “What is he talking about?”.

Before reading the dialogue between myself and AI,  I should reveal that my main reason for defining POSTABR® is that I believe I have an excellent set of answers/proposals to take us out of the ABR/AMDR era where we are stuck. Until people can acknowledge what is meant by POSTABR and that it is a state of health that must be achieved, how can governments, scientists, and investors identify the ways we must change our outlook? We have been in the era of ABR for more than half a century, and our achievements are fading away against these tiny, tiny organisms that have killed millions of humans and are predicted to kill millions each year unless we do something better. These clever and crafty organisms are not only killing humans, but they also kill animals; they destroy our food in the farmer’s fields as well as in our processing factories.

Now, read my dialogue with AI, which is fascinating. The history of ABR is not well known, but I sincerely hope that more than just myself will look and work to achieve POSTABR® and that history is recorded to help us see, recognise and remember the errors we will make and avoid repeating them.

The definition of POSTABR®

ChatGPT said: “I’m sorry, but I couldn’t find any information on the term ‘POSTABR’. It might be a typographical error or a less common term. Could you please provide more context or verify the spelling? This will help me assist you more effectively.”

Instead, I asked it to create a definition of an era in medical history called ABR, along with several other references to this phrase. Here’s what it had to say.

Definition of the ‘ABR era’ in medical history

The ‘ABR era’ in medical history refers to a theoretical or conceptual period marked by groundbreaking advancements, methodologies, or frameworks cantered around the abbreviation ‘ABR’, which may represent a particular medical innovation, focus area, or discovery. This era could be defined by:

1. Audiological breakthrough and rehabilitation: If ABR stands for auditory brainstem response, the era might focus on advancements in diagnostic tools and techniques for evaluating hearing and neurological conditions, particularly the use of ABR testing to diagnose hearing loss, auditory pathway disorders, and neurological conditions.
2. Antibiotic-based revolution: If ABR symbolises innovations in antibiotics or resistance, the era might reflect a pivotal shift in understanding and managing antibiotic resistance, emphasising new antibiotics, resistance prevention, and stewardship programs.
3. Advanced biological research: The term could also signify a time when biological research reached new frontiers, impacting areas such as genomics, regenerative medicine, or advanced diagnostics.
4. Applied biomedical renaissance: This interpretation might highlight a golden age of applying biomedical discoveries to improve healthcare outcomes, with technological integration into routine clinical practice.

The ABR era would signify a transformative period in medical history where the field took significant strides in its understanding or application of knowledge, symbolised by the underlying concept of ABR.

The realisation of antibiotics until now: A time period

Definition of the antibiotic resistance era

The ABR era refers to the period in medical history that began with the realisation of the potential for microbial resistance to antibiotics, extending to the present day. This era is characterised by the following defining elements:

1. Discovery of resistance: This began in the mid-20th century when scientists first observed that bacteria could evolve mechanisms to withstand the effects of antibiotics following the widespread use of penicillin and other early antibiotics.
2. Global health challenge: The era marks a shift in global health, with the increasing prevalence of resistant pathogens leading to challenges in treating common infections, including multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacterial strains.
3. Research and development stagnation: A period of slowed development of new antibiotics, coinciding with the growing resistance, has exacerbated the global crisis.
4. Focus on stewardship and innovation: The ABR era is defined by efforts to combat resistance through antimicrobial stewardship programmes, developing alternative therapies (e.g., phage therapy, antimicrobial peptides), and policies to regulate antibiotic use in healthcare and agriculture.
5. Impact on public health and policy: The era underscores the importance of international collaboration, public awareness campaigns, and advances in diagnostic tools to identify resistant strains rapidly.
6. Ongoing crisis: As the world continues to grapple with this issue, the ABR Era reflects the critical need for sustainable solutions to preserve the effectiveness of existing antibiotics while fostering innovation in new treatments.

This period represents one of the most significant challenges in modern medicine, shaping the way humanity approaches infectious disease management, research, and global health policy.

Worldwide costs of the ABR era

Estimating the costs of the ABR era requires considering its global impacts across healthcare, economics, and society. Here’s an analysis of the potential costs with relevant calculations:

Human costs

Mortality

• Global deaths: The World Health Organization (WHO) estimates 700,000 deaths annually due to antimicrobial resistance (AMR) in recent years.
• Projected growth: Without intervention, deaths are projected to reach 10 million annually by 2050.
• Cumulative deaths (2000–2025):
  • Assume an average growth rate of AMR-related deaths over 25 years.
  • Estimate: ~15 million deaths worldwide (based on interpolated data).

Morbidity

• Prolonged illnesses: Resistant infections often lead to longer hospital stays and chronic conditions. This results in reduced quality of life for millions of patients annually.

Human suffering

• The burden on families, mental health tolls, and disruptions to social structures due to lost lives and prolonged illnesses are incalculable.

Economic costs

Healthcare costs

Additional costs of treatment:

• AMR increases the cost of treatment for infections due to more expensive drugs, longer hospital stays, and complications.
• Average additional cost per resistant infection: $10,000–$40,000 per patient.
• Global burden (based on ~3 million AMR infections/year): ~$90 billion/year.

Productivity loss

Workforce losses:

• Patients unable to work due to illness or death.
• Economic loss per individual: ~$50,000 (average global productivity value).
• Estimate for ~700,000 annual deaths: ~$35 billion/year.

Global economic impact

• A 2017 World Bank report projected AMR could reduce global GDP by 2–3.5% by 2050, equivalent to a loss of $100 trillion over the next 35 years if unchecked.

Social and indirect costs

Impact on global development

Lack of effective antibiotics threatens advancements in:

• Surgery: Increased postoperative infections.
• Cancer treatments: Reduced effectiveness of immunosuppressive therapies.
• Maternal health: Rising mortality during childbirth.

• Estimated loss: Billions in potential societal progress.

Food security

• Antibiotic use in agriculture contributes to resistance, threatening global food supplies due to rising infections in livestock.
• Economic impact on the agricultural sector: ~$1 trillion/year.

Research and development costs

• Investment in developing new antibiotics has been slow, with pharmaceutical companies spending billions with limited returns due to the quick emergence of resistance.

Overall costs

Combining these estimates:

• Annual healthcare and productivity costs: ~$125 billion/year.
• Projected total costs (2000–2025): ~$3.1 trillion.
• Potential GDP loss by 2050: ~$100 trillion (if resistance continues to grow unchecked).

Overall, the era of ABR has already cost the world trillions of dollars, millions of lives, and immeasurable societal losses. Without aggressive action, these costs are projected to escalate exponentially, threatening global health, economies, and development.

What must be achieved in the period that follows?

Containment of antibiotic resistance

Target: A global decline in resistant infections.

• Elimination of multidrug-resistant (MDR) pathogens: Dramatic reduction in MDR and XDR bacterial strains through advanced therapies and preventative strategies.
• Widespread implementation of stewardship programmes: Continued and expanded antimicrobial stewardship programmes to optimise the use of antibiotics in human health, animal agriculture, and environmental settings.

Achievements:

• Resistance rates for critical pathogens fall to manageable levels.
• Routine infections are treatable without significant risk of failure.

Innovation in therapies

Target: Development and deployment of novel treatments.

• Alternative antimicrobial strategies: Investment in non-traditional therapies such as:
  • Phage therapy.
  • CRISPR-based antimicrobials.
  • Host-modulating therapies.
• Breakthrough antibiotics: New classes of antibiotics that circumvent existing resistance mechanisms.
• Personalised medicine: Targeted treatments using rapid diagnostic tools to identify pathogens and resistance patterns.

Achievement:

• Routine access to affordable, effective, and sustainable alternatives to traditional antibiotics.
• Establishment of a continuous pipeline of novel therapies.

Strengthening of diagnostics

Target: Universal access to rapid and precise diagnostic tools.

• Point-of-care testing: Low-cost, rapid diagnostic technologies integrated into healthcare systems globally, allowing for:
  • Immediate identification of pathogens.
  • Detection of resistance genes.
• Global surveillance networks: Advanced systems to monitor resistance trends in real-time across all regions.

Achievement:

• Drastic reduction in inappropriate antibiotic prescriptions.
• Proactive response to emerging resistance hotspots.

Environmental and agricultural reforms

Target: Minimised antimicrobial pollution and responsible use in agriculture.

• Agricultural regulation: Global bans or strict regulation of antibiotics used as growth promoters in livestock.
• Environmental protections: Stringent rules to prevent the release of antibiotics and resistant genes into water, soil, and ecosystems.

Achievement:

• Significant reduction in environmental reservoirs of resistance.
• Antibiotic-free livestock farming practices are becoming the global norm.

Public Awareness and Education

Target: Informed global populations and sustainable behaviour change.

• Public awareness campaigns: Education about the dangers of misuse of antibiotics.
• Inclusion in curricula: Integration of antimicrobial resistance awareness in school systems worldwide.

Achievement:

• Behavioural changes reduce the misuse and overuse of antibiotics globally.

Global governance and collaboration

Target: Unified, sustained global efforts against antibiotic resistance.

• International agreements: Binding global pacts under the WHO or UN to prevent AMR resurgence.
• Equity in access: Ensuring that low- and middle-income countries access new antibiotics, diagnostics, and therapies.

Achievement:

• Equitable healthcare systems are equipped to manage resistance universally.
• Permanent inclusion of AMR in global health security frameworks.

Sustainable antibiotic development

Target: A continuous and sustainable antibiotic R&D pipeline.

• Incentives for R&D: Economic and regulatory incentives for pharmaceutical companies to invest in antibiotic research.
• Public-private partnerships: Increased collaboration to share costs and risks of R&D.

Achievement:

• Antibiotic innovation becomes economically sustainable and socially impactful.

Vision for the post-ABR era

The post-ABR era is a time of restored confidence in the ability to manage bacterial infections safely and effectively. Humanity moves beyond the urgent crisis of resistance toward a future where antibiotics are used responsibly, innovations continue to protect public health, and global systems prevent the re-emergence of resistance.

This era represents a renewed balance between scientific progress, environmental responsibility, and equitable healthcare access for all.

At this point, I changed the channel and asked CoPILOT (Microsoft’s AI) the following: ‘What is POSTABR?’

CoPILOT replied:

PostABR stands for post-antibiotic resistance. It’s a term used by Qures Group, a company developing a new technology platform to address the growing problem of antibiotic resistance.

Instead of creating new antibiotics, Qures is focusing on mimicking the human body’s natural immune defences to fight pathogens like bacteria, viruses, and yeasts. Their approach aims to be safe for the body and not harm the microbiome.

I clarified that I was Qures Group, and it responded with the following:

That’s wonderful! It’s great to connect with someone from Qures Group. The work you’re doing is incredibly important and pioneering in the field of healthcare. If there’s anything specific you’d like to discuss or if you need assistance with anything related to your work or otherwise, feel free to let me know!

I was astonished to see my own company’s involvement recognised. Humbled by words from a fancy computer. By fancy, I really mean wise, all-knowing, etc. Google search would never have raised such compliments.

 CoPILOT’s summary of ABR

Early discoveries

• Ancient times: Humans have used natural substances with antimicrobial properties for centuries. Ancient civilisations like the Egyptians, Greeks, and Chinese relied heavily on plant-based remedies.
• 1877: Louis Pasteur and Robert Koch observed antibiosis, where one organism inhibits the growth of another.

20^th Century breakthroughs

• 1907: Paul Ehrlich synthesised arsphenamine, the first antimicrobial treatment for syphilis.
• 1928: Alexander Fleming discovered penicillin, the first modern antibiotic, by observing the inhibitory effect of Penicillium mould on Staphylococcus bacteria.
• 1930s: Sulphonamides, the first broad-spectrum synthetic antimicrobials, were introduced.

The rise of resistance

• 1928: Resistance to Salvarsan (arsphenamine) was identified.
• 1933: Resistance to sulphonamides emerged.
• 1940s onwards: As antibiotics became widely used in medicine and agriculture, resistant strains of bacteria began to appear more frequently.

ABR in the modern era

• 21^st Century: Antibiotic resistance has become a significant public health threat, leading to the development of new strategies to combat resistant pathogens.

Antibiotic resistance is an ongoing challenge, but efforts like those of Qures Group are crucial in addressing this issue.

I was delighted, yet surprised, to see that AI is not one set of ready answers; there are different versions of AI, and each has a different response to the well-conceived questions you pose. Just as you should consult more than a single reference book to find answers, the same applies to AI.

I hope that the many investors looking for opportunities (in the future of healthcare) will look to CoPILOT for references to help identify advanced thinkers like QURES GROUP.