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About Antibiotics Resistance

In 1930, when the modern era of chemotherapy began, it felt as if infectious diseases appeared to be all but conquered. With the help of sulfonamides in clinical usage, antibiotics proved to be too good for infections. Due to their effectiveness, they were spread too widely and cheaply. It was the effectiveness of antibiotics at that time which led to the generation of antibiotic resistant organisms.

The primary contributor to this problem was the fact that we underplayed the strength of microbes. Infectious diseases is one of the most rapidly changing disciplines in medicine. In most specialties of medicine, diseases remain relatively stable and the diagnostic and therapeutic modalities may change rapidly.

Even the disease patterns change due to the following reasons:

  • Emergence of new pathogens
  • Resurgence of pathogens
  • Changes in the host
  • Prescription of Antibiotics
  • Development of microbial resistance

Epidemiological studies from various parts of our country are presented in this special issue. Each study leads towards one direction, “Antibiotic resistance has reached alarming proportions.” It is due to these studies that are helping in formulating guidelines which can help us achieve the objectives.

These include:

  • Maximizing the outcome for an individual patient
  • Minimizing the collateral damage to our microbial environment

How does Antibiotic resistance work?

There are several ways in which an antibiotic resistance can be demonstrated. First is intrinsic resistance wherein an inherent attribute of a particular genus and species. Secondly, an acquired resistance, wherein a true change in the genetic composition renders drug ineffective. It is because bacteria may combine multiple mechanisms against one or more antimicrobials and so become resistant to several different agents.

How is Antibiotic resistance widespread?

Mutations of resident genes can be spread from cell to cell by mobile genetic elements such as plasmids, transposons and bacteriophages. The resistant bacteria flourish in areas of heavy antibiotic use such as hospitals and ccUs. The resistant factors can then spread far and wide through the networks of bacterial populations. The impact of antimicrobial resistance is tremendous. It increases the morbidity, mortality and costs associated with infectious diseases.

What problems are being caused by it?

Effective therapy is delayed, particularly when resistance emerges to the drug of choice for a particular organism or to the appropriate empiric therapy for a given syndrome. The infected person continues to transmit the resistant organisms for a longer period until an effective treatment for those organisms is used by continuing to use the usual therapy which is ineffective, the susceptible strains are subdued, and the resistant ones are at a selective advantage. Since resistance to a particular antibiotic is often a part of a larger package of resistance factors located on plasmids or transposons, simply using combinations of antibiotics in place of one may not work