More than half a century after antibiotics transformed modern medicine, their effectiveness continues to decline in ways that many researche...

More than half a century after antibiotics transformed modern medicine, their effectiveness continues to decline in ways that many researchers find deeply troubling. A recent multinational report, which examined prescribing data from over 150 healthcare systems, introduced a measure called “selection pressure”, a concept that takes into account not only how often an antibiotic is prescribed but also (18) __________. When researchers compared data from 2014 to 2023, they found that resistance rates had risen across several major bacterial groups, a pattern that suggests mounting strain on public health systems.

The rise in antibiotic resistance is linked to two interrelated developments: clinicians are relying on larger volumes of antibiotics, and (19) __________, a shift that has been driven by the rapid spread of resistant infections. As resistance intensifies, health systems that depend heavily on pharmaceutical treatment often feel compelled to adopt broader-spectrum drugs, which, although effective in the short term, (20) __________. Certain antibiotic classes, particularly fluoroquinolones and third-generation cephalosporins, have attracted growing concern because of the selective pressure they exert across a wide range of pathogens.

Efforts to reduce unnecessary antibiotic use, while widely supported, involve difficult trade-offs, (21) __________, thereby increasing the likelihood of complications in vulnerable patients. Although many countries have pledged to curb inappropriate antibiotic use by 2030, (22) __________, leaving specialists concerned that current policy frameworks may be inadequate to the scale of the problem.

Question 18:

A. how severely each substance affects a range of bacterial populations

B. which bacterial populations are severely affected by each substance

C. how much damage is done by bacteria to each substance used

D. each substance affects a range of bacterial populations severely

Question 19:

A. older antibiotics are being progressively replaced by broader-spectrum ones

B. broader-spectrum antibiotics progressively replaced the older ones being used

C. the replacement of older antibiotics are increasingly broader-spectrum ones

D. broader-spectrum ones are older antibiotics being progressively replaced

Question 20:

A. are a major environmental risk in the immediate future

B. can intensify long-term resistance risks

C. a long-term risk to resistance is significantly increased

D. the long-term risk of resistance has been intensified

Question 21:

A. because restricting access too sharply may delay timely treatment

B. when timely treatment is delayed by restricting access too sharply

C. whereas restricting access too sharply is delaying timely treatment

D. despite the fact that timely treatment may sharply restrict access

Question 22:

A. measuring progress is shared by the difficulty of defining inappropriate use

B. a shared definition of inappropriate use makes progress difficult when measured

C. progress remains difficult to measure without a shared definition of inappropriate use

D. the difficulty in progress is measured by defining inappropriate use in common