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Antibiotic Resistance

Antibiotic resistance is an inability of drugs to control bacteria effectively; stay resistant and multiply inspite of the presence of antibiotic.

Antibiotic resistance is actually a natural phenomenon. When a patient takes an antibiotic, those bacteria which can resist its effect stand a bigger chance of survival than those which undergo the influence of that antibiotic. As a result, susceptible bacteria die.

In some cases, drug resistance does not depend on a patient and occurs without human action. This happens because bacteria can produse their own antibiotics using them against other sorts of bacteria. Some bacteria acquire resistance to antibiotics by a genetic mutation. Mutations are spontaneous changes in the genetic material of the bacteria. Different sorts of genetic mutations produce different sorts of resistance. For example, some mutations keep bacteria from producing potent chemicals that can inactivate antibiotics, others can distract the cell target that undergoes the effect of antibiotics.

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In some other cases bacteria can acquire gens of resistance to antibiotics from other bacteria. “By undergoing a simple mating process called “conjugation”, bacteria can transfer genetic material, including genes encoding resistance to antibiotics (found on plasmids and transposons) from one bacterium to another. Viruses are another mechanism for passing resistance traits between bacteria. The resistance traits from one bacterium are packaged into the head portion of the virus. The virus then injects the resistance traits into any new bacteria it attacks. Bacteria also have the ability to acquire naked, “free” DNA from their environment.”

As far as bacteria can collect resistance traits, they can be resistant to a wide range of antibiotics. However, most patients suffer from antibiotic resistance for the abuse and overuse of antibiotics. Nowadays, there are a lot of countries, where antibiotics can be bought without any prescription from the doctor. Besides, we all have a possibility to purchase different sorts of antibiotics over the Internet. This leads to taking antibiotics unnecessarilly, while treating different sorts of viral diseases like the common cold, which, in fact, do not need any antibiotics to be cured.

The only way to know if the cold is a bacterial infection is to consult a doctor. Otherwise there is no way to find out whether any antibiotic is needed to treat the disease. Abuse and the improper use of antibiotics lead to occuranse of antibiotic resistance. Among the most common abuse and misuse of antibiotics are:

Mistaken prescribing antibiotics to treat the viral infections by the doctors;

  • Not taking as many pills of antibiotic as it it prescribed be the doctor.
  • When the full dosage of antibiotic is not finished, some bacteria are left alive and quite “resistant” to this sort of antibiotic treatment.
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Doctors and patients have to pay attention to the factors that cause antibiotic resistance and try to decrease it. All kinds of antibiotics have to be prescribed only if a test shows that bacterial infection is present. In case of viral infections, antibiotics have no power; they are not effective which means that there is no use from them while treating a viral disease.

Patients should always prove themselves that they have bacterial infection by asking doctor about that. Otherwise, there is no sense to take antibiotics.

Evolutionary biology makes sure that spread and emergance of antibiotic resistance is mainly caused by the drug selection preasure. In spite of the fact that the reationship between drug resistance and antimicrobial use is well-established within the developed countries, we cannot say the same thing about developing countries mostly for the reason of a lack of the information on how to use the antibiotics. Resistance to antimicrobials stands less chances to arise in the poorly developed countries just because of much lower rates of antibiotic use related to poor economic status.

India is a large country with a poor control over antibiotic use – it does not have any problem with drug resistance especialy in rural arears. It does not mean that there is no antibiotics in the country, the situation is associated with extreme poverty which keeps people from purchasing them. Increased affordability of antibiotics and rising incomes will definitely change this low rates of antibiotic resistance. “The same may be true of quinolones, which are widely available at relatively affordable prices, even in semirural and rural areas. This trend may be responsible for the emergence of nalidixic acid resistance to Shigella in Bangladesh and fluoroquinolone resistance to Salmonella typhi in India” (Jamison , 2006).

Extremely low levels of resistance to antibiotics can also be observed in isolated communities on the rural african arears. This does not mean that situation is stable. If there is no any control over the antibiotics use, an increased access to drugs can lead the developing countries to the highest level of antibiotic resistance in the world. This happened to Vietnam.

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Countries who are considered relatively wealthy such as Japan and South Korea either have lax conrol as well as a great access to purchasing antibiotics. “Patterns of resistance differ by antimicrobial class, and resistance to several classes has been linked to particular patterns of use in developing countries. Macrolide use in children in China may be preferred to the use of beta-lactams, which are known to be associated with serious anaphylactic reactions; in Beijing and Shanghai, the highest global rates of macrolide resistance are encountered in nasopharyngeal isolates from children” (Jamison , 2006). Tetracycling is widely spread mainly in developed countries, while the poor African countries, i.e. Central African Republic, are likely to have higher level of resistance to tetracycling rather than to macrolides or beta-lactams.

The proper way of drug treatment plays an important role in eliminating the evolution of antibiotic resistance. Combinations of drugs, which include different targets are effectively used to treat tuberculosis, HIV/AIDS and cancer. Combinations of artemisinin with other antimalarials accelerate recoveries, reduce transmissibility and increase cure rates.

The use of combinations stopped the development of antibiotic resistance as well as increased the rate of treatment in the refugee camps in Thailand. If the resistance is caused by the spontaneous genetic mutations, the chance of parasite to emerge is the product of the frequencies of parasite mutation multiplied by the number of bacteria exposed to the antibiotic. The task of the combinations is to reduce the probability the resistant mutation arising.

Some facts about antibiotic-resistant bacteria:

  • Infections, produced by resistant bacteria do not respond to treatment thus leading to prolonged illness and increasing chances to die;
  • Resistant bacteria of tuberculosis require less expensive and much longer course of treatment. According to WHO, nowadays there are approximately 630000 MDR-TB cases all over the world;
  • Currently, the new resistant bacteria have occurred that make the new generation of antibiotics ineffective.

WHO calls on patients and public, prescribers and practitioners, dispensers and pharmacists to take responsibility for delaying antibiotic resistance.

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