Antibiotic resistance refers to changes in bacteria that enable them to survive antibiotic exposure. Such bacteria cause infections, increase treatment and recovery times, and lead to higher mortality rates. Close to 1 million patients die each year due to infections that can no longer be successfully treated with a range of antibiotics.
Mechanisms That Bacteria Develop
Bacteria use a number of mechanisms to survive exposure, including changing and destroying antibiotics and releasing enzymes which change drugs so that they become ineffective. Some bacteria such as Pseudomonas aeruginosa use pumps to prevent drugs from entering through their walls. Such drugs are, for example, trimethoprim, chloramphenicol, beta-lactams, and fluoroquinolones.
Some bacteria have low to medium antibiotic resistance, including mycobacterium tuberculosis, neisseria gonorrhoeae, and streptococcus pyogenes. Such bacteria can be deadly and cause diseases such as gonorrhea, meningitis, tuberculosis, diarrhea, pneumonia, and lung infections. Some bacteria such as Pseudomonas aeruginosa mainly affect people with compromised immune systems, including patients with cystic fibrosis, cancer, and AIDS.
In general, bacteria can be divided into gram negative and gram positive. Enterobacteriaceae are gram negative and are resistant to antibiotics such as nalidixic acid, tetracycline, and ampicillin. Examples of gram positive bacteria include Streptococcus, Mycoplasma genitalium, Enterococcus, and Clostridium difficile. They cause diseases such as peritonitis, otitis media, arthritis, and bacteremia and are resistant to a number of antibiotics, including tetracycline, methicillin, penicillin, and erythromycin.
Scope and Prevention
One of the main problems is that in some parts of the world, antibiotics are sold without prescription. Countries where it is easy to obtain medications without a prescription include Ethiopia, Saudi Arabia, Syria, and Indonesia. Studies show that antibiotics offered without a prescription include azithromycin and amoxicillin. Amoxicillin, for example, is used to treat a number of infections such as skin, stomach, and respiratory infections, including pneumonia and bacterial sinusitis. Azithromycin is also used to treat bacterial infections such as intestinal infections, traveler’s diarrhea, pneumonia, strep throat, and middle ear infections. The use of such critically important medications without a prescription results in antibiotic resistance. This is considered a major health threat in light of the fact that antibiotics are used to treat multiple serious bacterial infections. Prevention is the key to reducing the spread of resistance. This can be done by educating patients and making information widely available. Policy makers must develop and improve plans, programs, and policies as well as strategies for control and prevention. It is also important to develop policies to regulate prescription, disposal, and use of antibiotics. The general public is advised to keep immunizations to date, limit contact with sick persons, handle and prepare food safely, and frequently wash hands. Antibiotics must only be used as and when prescribed. Over-use by patients and over-prescription by health professionals are major problems that require urgent and comprehensive measures. Health professionals are advised to monitor and report on infections, prescribe medications as per national standards and guidelines, and keep their work environment and instruments clean. They are also advised to discuss with patients the ways to prevent infections, including hand washing and vaccinations. It is also important that the research community focuses more on the development of diagnostic methods and tools and on new antibiotics that can effectively treat serious and life-threatening infections.