Introduction to Antibiotic Resistance

Several medical procedures are dependent on antibiotics to fight infections. Procedures, such as organ transplants, joint replacements, and cancer therapy, require antibiotics. So do chronic diseases, such as diabetes, asthma, and arthritis.

Antibiotic resistance occurs when microorganisms like bacteria and viruses develop immunity to the drugs designed to kill them. Antibiotic resistance makes infections harder to treat, sometimes even impossible to deal with. These antibiotic-resistant infections can result in more medical consultations and extended hospital stays. They may require alternative medications that cost more and are more toxic than common antibiotics.

Antibiotic resistance is considered a global health concern because it can affect patients at every stage of life. It can also impact several fields beyond healthcare, like the veterinary and agricultural fields. In the United States, approximately 2.8 million people are affected by antibiotic resistance every year. Of those affected, about 35,000 die because of antibiotic resistance.

The first antibiotic was penicillin, discovered by Alexander Fleming in 1928. Since that time, three penicillin-resistant germs have been identified. Penicillin-resistant Staphylococcus aureus was identified in 1942. Streptococcus pneumoniae in 1967, and Neisseria gonorrhoeae in 1976. To date, none of the new antibiotics being developed are expected to be effective against the most dangerous types of antibiotic-resistant bacteria.

Globally, the World Health Organization (WHO) has noted that antibiotic resistance is on the rise. Diseases such as tuberculosis, pneumonia, and gonorrhea, are increasingly becoming antibiotic-resistant. So are foodborne illnesses and blood poisoning. Antibiotic resistance is caused by misuse and poor infection control and prevention.

There are several ways that individuals and organizations can do to prevent antibiotic resistance. Individuals are counseled only to use antibiotics when prescribed by a medical professional. Self-prescription or demanding antibiotics against the advice of a certified health professional is discouraged. Individuals should also strictly follow the instructions given by their doctors on the use of antibiotics. Antibiotics must never be shared with other individuals who have not been prescribed the use of such medicines.

For health professionals, cleanliness is the first line of defense against antibiotic resistance. For such professionals, guidelines are available for dispensing antibiotics. Health professionals should also report the occurrence of antibiotic resistance to help national and global efforts to monitor and control antibiotic resistance. A proactive way for the healthcare industry to combat antibiotic resistance is to continue developing new antibiotics as old ones become less effective.

For national policymakers, the WHO advises creating systems to monitor the occurrence of antibiotic resistance and create programs to prevent antibiotic resistance. This program should include the organized disposal of medicines.

Besides people, animals are also affected by antibiotic resistance. The veterinary community and agricultural industry are also given guidelines to prevent antibiotic resistance in animals. Antibiotic resistance in animals could impact both national and global food supplies. Those raising animals in the agriculture industry are advised by the WHO only to use antibiotics under the supervision of veterinarians. Antibiotics should only be used to combat an existing disease, never for disease prevention or to promote the growth of livestock.

Through the United Nations, the WHO has been spearheading global efforts against antibiotic resistance. The effort aims to improve awareness, strengthen surveillance, optimize the use of antibiotics, reduce the incidence of infections, and ensure adequate investments devoted to funding activities that counter antibiotic resistance.

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Antibiotic Resistance - Causes

Antibiotics are a class of medications used to treat bacterial infections. Discovered in the 19th century, antibiotics remain one of the most commonly prescribed medications in the world. However, many bacterial strains, including those responsible for tuberculosis and sexually transmitted infections, are becoming more resistant to available antibiotics. This phenomenon, known as antibiotic resistance, is growing more prevalent.

The World Health Organization ranks antibiotic resistance as one of the most challenging global health issues, and the consequences are severe. The Centers for Disease Control and Prevention projects that more than 30 million Americans with chronic illnesses are at risk of contracting drug-resistant infections, while a further 650,000 individuals with cancer are vulnerable to bacterial infections due to chemotherapy and other treatments. Physicians also prescribe antibiotics preventatively for several conditions, including post-surgery to prevent infections. As more bacteria become resistant, the risk of contracting a fatal infection increases.

Antibiotic resistance has several causes. For many decades, doctors prescribed antibiotics for patients with viral infections, creating a medical culture that fostered antibiotic overuse. This proves especially prevalent in countries where antibiotics have become recently available. The use of antibiotics in patients without bacterial infections does not alleviate symptoms or accelerate wellness; instead, it destroys harmless bacteria and increases the likelihood of these strains developing resistance. Bacteria can then pass on their resistance mechanism to other, more dangerous strains.

Resistance also develops due to the misuse of prescription antibiotics. People often stop taking their medication once their symptoms have disappeared. However, if a patient does not finish the full course of antibiotics, a sizable percentage of the bacteria remains. These bacteria, which were already more difficult to kill, now require more intensive and longer treatments than the original strain.

A similar reaction occurs due to antibiotic use in livestock. Farmers may give antibiotics to an entire herd to prevent an outbreak. Since many of the same bacteria that infect animals can also infect humans, this can accelerate antibiotic resistance.

Another emerging issue involves the appearance of pan-resistant bacteria. There are more than two dozen different types of antibiotics, such that if a bacterial infection does not respond to one type, another, stronger type may be effective. However, several bacterial strains have developed resistance to several classes of antibiotics, and some strains of staphylococcus and E. coli have become resistant to all known antibiotics. These “superbugs” can require more extensive treatment and result in costly hospital stays; in the worst-case scenario, these infections can be fatal.

Infectious disease experts advocate for changes to both individual behaviors and industry-wide practices to prevent antibiotic resistance. People should practice basic hygiene to avoid becoming infected with bacterial infections in the first place. In addition, doctors advise completing all rounds of prescribed antibiotics, and never taking them unless prescribed.

Moreover, experts call on the agricultural sector to eliminate widespread antibiotic use. Health care workers must also be vigilant about the spread of resistant strains in the hospital setting by following sanitation protocols and recording any instances of these infections.