I. Introduction
Antibiotics are pivotal in treating bacterial infections, which was one of the most important discoveries of the 20th century. However, now microbes have learned to adapt to the killing (bactericidal) or growth-hindering (bacteriostatic) effects of these drugs.
This antibiotic resistance not only challenges the achievements of modern medicine but also imposes an economic burden. To curb this growing threat, pharmaceutical companies are actively working on solutions to address this issue.
II. Understanding Antibiotic Resistance
Resistance is usually defined as a function of minimum inhibitory concentration (MIC), which is defined as the lowest concentration of a drug that will inhibit growth of microbes. If this MIC for any drug lies on the resistant part of the scale, the organism is considered to have resistance to that drug.
Natural resistance (intrinsic) is when the genes are exist in the species, but only become active following exposure a drug.
Acquired resistance is the transfer of genetic material via transformation, transposition or conjugation; plus mutations to its own genetic material.
A. Mechanisms of Resistance
Limiting uptake of drug: Outer membrane of gram negative bacteria creates a shield due to the presence of lipopolysaccharide (LPS), which makes penetration through outer membrane more resilient. Porin channels also allow access to drugs, however reduction in number of porins present and mutations that alter the selectivity of porins channels can be a challenge to drug uptake.
Drug efflux: Drugs are pumped out by energy dependent transport system, which are used to rid the toxic substance. Higher levels of mutations or stimuli will lead to intrinsic resistance.
Modification to drug target: modification to components of the bacterial cell that are targets of antimicrobial agents will enable resistance to those drugs. For example mutations in the enzymes (di hydrofolate reductase) will affect the drugs that inhibit metabolic pathways.
Drug inactivation and chemical modification: By transferring a chemical group in to the drug.
B. Common Resistant Bacteria
HIV drug resistance occurs due to changes in the HIV genome that impair the effectiveness of antiretroviral medications, it can be transmitted at the time of infection or developed from poor adherence to treatment.
Tuberculosis significantly contributes to antimicrobial resistance, multi-drug resistant tuberculosis (MDR-TB) is caused by bacteria that do not respond to isoniazid, and rifampicin, the most effective first line TB medication.
A strain of Staphylococcus aureus resistant to methicillin and beta-lactam antibiotics. Usually associated with skin infections, Methicillin-Resistant Staphylococcus aureus (MRSA) can lead to severe health complications in hospital settings.
First-line treatment for uncomplicated Plasmodium falciparum malaria, Artemisinin-based combination therapies (ACTs) are widely used in malaria-endemic regions. However, the emergence of partial resistance to artemisinin or its partner drugs complicates treatment selection.
III. Causes of Antibiotic Resistance
A. Over-prescription of Antibiotics
Antibiotics are frequently overprescribed for conditions that are viral in nature, such as the common cold or flu. In fact, studies show that a significant portion of antibiotic prescriptions are unnecessary. This over-prescription not only fails to help the patient but also accelerates the development of resistance in bacteria.
B. Misuse of Antibiotics
Patients sometimes misuse antibiotics by not completing their prescribed courses, or by self-medicating with leftover antibiotics.
C. Poor Infection Control Practices
In hospitals and healthcare settings, improper sanitation, lack of infection control measures, and overuse of antibiotics contribute to the spread of resistant bacteria. Inadequate hygiene and insufficient sterilization protocols allow bacteria to flourish, making healthcare-associated infections more difficult to control.
IV. Consequences of Antibiotic Resistance
A. Impact on Individual Health
The most direct consequence of antibiotic resistance is the increased morbidity and mortality associated with infections that were once treatable. Common conditions, from pneumonia to urinary tract infections, can become life-threatening. Complications arise during surgical procedures, cancer treatments, and organ transplants, where the risk of infection is high and resistant pathogens complicate recovery.
B. Economic Implications
The economic toll of antibiotic resistance is staggering. Prolonged hospitalizations and complicated treatments for resistant infections drive up healthcare costs. Patients may require longer stays, more intensive care, and alternative treatments that are more expensive.
C. Public Health Threat
The global spread of resistance poses a major public health risk, potentially leading to pandemics that are harder to control.
V. Solutions and the Path Forward
Addressing antibiotic resistance requires a multi-faceted approach. First, we must prioritize responsible prescribing practices, ensuring antibiotics are used only when necessary and for the appropriate duration. Public health campaigns are also essential in educating patients and healthcare workers about the dangers of misuse and overuse.
Investment in research and development for new antibiotics, alternative therapies, and vaccines is crucial. Finally, infection control practices must be strengthened globally, particularly in hospitals and healthcare settings. Improved sanitation, hygiene, and surveillance are essential to preventing the spread of resistant bacteria.
VI. Conclusion
Antibiotic resistance is one of the greatest challenges facing modern medicine. The rise of resistant bacteria threatens our ability to treat infections, perform surgeries safely, and manage chronic conditions. However, with joined effort from governments, healthcare professionals, and the public, we can slow the spread of resistance and protect the efficacy of antibiotics for future generations. It is imperative that we act now, before we lose the battle against these “superbugs.”
VII. Reference
Morier, Douglas. "antibiotic resistance". Encyclopedia Britannica, 24 Sep. 2024, https://www.britannica.com/science/antibiotic-resistance. Accessed 9 October 2024.
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