Antibiotic resistance is an emerging phenomenon around the world, which has now being recognized as a developing threat needing urgent global effort to contain, at least in its present state.
What is antibiotic resistance?
If a bacterium does not respond to an antibiotic which has earlier known to be effective towards the same bacteria, the bacteria has developed resistance towards that particular antibiotic. However, it should be remembered that, the phenomenon could take place with other antimicrobials such as anti-virals as well.
How does antibiotic resistance develop?
When antibiotics are used to treat bacterial diseases, not all bacteria will die or become disabled but some would remain. The reason for these bacteria to remain is the presence of resistance genes within their genetic material and therefore develops the ability to adapt towards antibiotic use. As bacteria can replicate by division, it is possible for resistance related genes be inherited by replicated bacteria. At the same time, a bacteria containing antibiotic resistance gene can exchange the said gene as a plasmid directly into a nearby bacteria through a mechanism known as ‘conjugation’. Thus, multiple bacteria can become antibiotic resistant without the need to replicate at all. With time, when such bacteria become abundant, they will act as pathogens and the diseases manifesting due to such bacteria will not respond to the same antibiotic, which was effective earlier.
Thus, the process of developing antibiotic resistance is a natural phenomenon. However, certain factors have accelerated its emergence largely and unless remedial measures are taken, it can develop into a state, which may convert an easily treatable viral cold in to a fatal disease condition.
What accelerates the occurrence of antibiotic resistance?
When antibiotics are used inappropriately, it can fuel the occurrence of antibiotic resistance. Thus, inadequate dosage, inadequate duration of treatment, improper selection of antibiotics, poor quality or counterfeit antibiotics, as well as prolonged use of antibiotics are some of the factors highlighted by organizations such as Center for Disease Control (CDC) and the World Health Organization (WHO). At the same time, self medication, direct advertising of medications to the patients, use of antibiotics for animal treatment and plant growth have also been linked with its emergence.
Similarly, increased usage of antibiotics will invariably lead to more chances of developing resistance while the increasing numbers of immune-compromised individuals such as HIV patients can also increase the likelihood.
At the same time, WHO emphasizes the fact that, hospital setting is a common site for developing antibiotic resistant due to the combination of highly susceptible patients, intensive and prolonged antimicrobial use, and cross-infections.
What are the strategies to prevent antibiotic resistance?
Based on the nature of resistance development and the factors, which accelerate this process; following suggestions can be made towards antibiotic use by patients in order to avoid antibiotic resistance.
-Use of antibiotics for the recommended duration of time
-Using antibiotics at its optimal dose
-Avoiding the practice of self-treatment with antibiotics and the use of antibiotics for prolonged periods unless recommended by a physician for a valid reason
-Avoiding practices, which may cause antibiotics to act sub-optimally
-Not to pressurize health professionals in prescribing antibiotics when it is not indicated.
Prescribers and health care professionals should also adhere to certain guidelines and standards in order to avoid antibiotic resistance. These include,
-Choosing the correct antibiotic
-Avoiding using antibiotics to satisfy patients or else when it is not indicated.
-Starting with the first line drugs as against using broad-spectrum drugs when it is not indicated.
-Educating the patient regarding the importance of taking antibiotics at its recommended dose and for the prescribed duration even after symptoms subside
-Taking measures to prevent cross-infections
-Using good hygienic practices and barrier methods to prevent bacteria from spreading to other patients or colleagues
-Formulating and implementing infection control measures in the hospital setting.
Similarly, authorities will have their share of work to avoid antibiotic resistance as well. Thus, they should,
-Prevent counterfeit or sub-standard drugs from reaching the market,
-Issue policy decisions regarding prescription making and advertising of drugs directly towards patients,
-detect emerging resistance early and take remedial measures as appropriate,
-Discourage the use of antibiotics for plant and animal growth promotions.
Antibiotic resistance is a global threat, which requires a combined effort from patients, health care professionals, and authorities in all parts of the world with close supervision from authoritative bodies such as CDC and WHO.