The term antibiotic can be defined as “a chemical substance
produced by micro-organism having the property of inhibiting the growth or
destroying other micro-organisms in high dilution.”
-Waksman, 1944
The first antibiotic, Penicillin is identified by Sir Alexander
Fleming in 1928,while studying Staphylococcal variant .while it wasn’t distributed
among the general public until 1945.
Antimicrobial resistance: an introduction:
Antimicrobial resistance is resistance of a micro-organism to an
antimicrobial drug that was originally effective for treatment of infections
caused by it.
Resistant micro-organisms are able to withstand attack by
antimicrobial drugs such as antibiotics, antifungal, antiviral and
antimalarial ,so that standard treatments becomes ineffective and
infections persist, increasing the risk of spread to others.
The frequent use and misuse of antimicrobial drugs accelerates the
emergence of drug-resistant strains. Poor infection control practice,
inadequate sanitary conditions and inappropriate food handling encourage the
further spread of antimicrobial resistance.
Threats of antimicrobial resistance:
According to Centers for Disease Control and Prevention (CDC),
each year in the United States, at least 2 million people become infected with
bacteria that are resistant to antibiotics and at least 23000 people die each
year as a direct result of these infections.
According to a report published by CDC in 2013, top 18 drugs
–resistant threats are categorized as:
Urgent
threats:
There are high-consequence antibiotic resistant threats
because of significant risk identified across several criteria. These threats
may not be currently widespread but have potential to become so and require
urgent public health attention.
- Clostridium Difficile (CDIFF)
- Carbelpenen-Resistant
Enterobacteriaceae(CRE)
- Neisseria
gonorrhoeae
Serious
treats:
These are significant-antibiotic resistant threats. They are not
considered urgent but these threats will worsen and may become urgent.
- Multidrug-Resistant
Acinetobacter
- Drug-Resistant Campylobacter
- Fluconazole –Resistant Candied
- Extended Spectrum
Enterobacteriaceae(ESBL)
- Vancomycin-Resistant
Enterococcus (VRE)
- Multidrug –Resistant
Pseudomonas Aeruginosa
- Drug-Resistant Non Typhoidal
Salmonella
- Drug-Resistant Salmonella
Serotype Typhi
- Drug-Resistant Shigella
- Methicillin-Resistant
Staphylococcus Aureus (MRSA)
- Drug-Resistant Streptococcus
Pneumonia
- Drug-Resistant
Tuberculosis
Concerning
threats:
These are bacteria for which threats of antibiotic resistance are
low, and/or there are multiple therapeutic options.
- Vancomycin-Resistant
Staphylococcus Aureus
- Erythromycin-Resistant Group A
Streptococcus
- Clindamycin-Resistant
Group B Streptococcus
Consequences
of antibiotic resistance:
Physicians have to recommend second- or third-choice drugs for
treatment when the bacteria that cause infections are resistant to the drug of
choice and this drug don’t work. But the alternative drugs might be less
effective, more toxic, and more expensive.
Some other consequences are:
- Antimicrobial resistance may
kills patient
- Antimicrobial resistance
hampers the control of infectious disease
- Antimicrobial resistance
increases the cost of health care
- Antimicrobial
resistance jeopardizes health care gains to society
Actions
to decrease the problem of antimicrobial resistance:
Actions to be taken by people:
- Hand washing ,and avoiding
close contact with sick people if possible
- Getting proper vaccination
- Using antimicrobial drugs only
when they are prescribed by certified health professional
- Completing the full treatment
course, even if they feel better
- Never
sharing antimicrobial drugs with others
Actions to be taken by health workers and pharmacist:
- Enhancing infection prevention
and control in hospitals and clinics
- Only prescribing and dispensing
antibiotics when they are truly needed
- Prescribing and dispensing the right antimicrobial drugs to treat the illness
By- Sagar Baral
B.Pharm, CiST college, Kathmandu Nepal
Tags:
Health