Drug Resistance: Root Causes and Expanded Insights into Antimicrobial and Antibiotic Resistance
In a world where antibiotics and antimicrobial drugs have become a common part of modern medicine, a concerning trend is emerging: Antimicrobial Resistance (AMR). This phenomenon, where microbes no longer respond to drugs that previously treated them effectively, is a pressing issue that could potentially render common infections and minor injuries deadly once again.
The development and spread of AMR are influenced significantly by human actions. Here are some key ways in which our behaviour contributes to this issue:
1. **Inappropriate Use of Antimicrobials** - Overuse and misuse in healthcare settings, such as the unnecessary prescription and misuse of antibiotics, create selective pressure that favours the survival and proliferation of resistant bacteria. - The widespread use of antimicrobial drugs in agriculture, particularly in livestock farming, contributes to the emergence of resistant bacteria that can be transmitted to humans.
2. **Poor Infection Prevention and Control Practices** - Inadequate hygiene and infection control measures in healthcare settings allow resistant bacteria to spread more easily among patients.
3. **Environmental Factors** - Human activities, such as the disposal of antimicrobial waste into the environment, can facilitate the spread of resistant bacteria through water and soil.
4. **Travel and Trade** - The movement of people and goods across borders can spread resistant bacteria, further complicating global efforts to combat AMR.
5. **Lifestyle Choices** - Everyday choices, such as the demand for quick fixes and the lack of awareness about proper antibiotic use, fuel AMR without individuals realizing the impact.
Antimicrobial resistance is not limited to bacteria. It can also originate in fungi, parasites, and viruses, affecting people with conditions like Candida, malaria, HIV, and more. Preventing AMR requires only using antimicrobial drugs when a doctor prescribes them, completing the full prescribed course, never sharing or using leftover antimicrobials, not pressurizing doctors into prescribing antimicrobials, following good hygiene practices, getting recommended vaccinations, and avoiding the frequent and improper use of antimicrobial drugs.
Examples of AMR include resistance in bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and in viruses, such as influenza viruses resistant to antivirals. Fungal infections, like Candida resistant to antifungal drugs, and parasites, like malaria parasites resistant to antimalarial drugs, are also becoming resistant to antimicrobial treatments.
In the United States, doctors often prescribe antibiotics for a sore throat, even though only 15 percent of sore throats are due to streptococcal bacteria. Tens of millions of prescriptions for antibiotics that offer no benefit are written each year. Drug-resistant TB is more complex to treat, requiring the person to take the drugs for a longer time and needing close supervision. Gonorrhea cases of drug-resistant gonorrhea have started to occur, and now there is only one type of drug that is still effective against the drug-resistant form of this disease.
Scientists are investigating novel ways of combating bacteria, including using bacteriophages, developing vaccines, fecal microbiota transplant, and using probiotics to restore the gut flora. If AMR continues, it could lead to a post-antibiotic era, making common infections and minor injuries potentially deadly again. Understanding the role of human behavior in AMR requires an integrated approach that considers ecological, societal, and population-based factors.
- Contextual Use of Antimicrobial Drugs in Health-and-Wellness - The demand for quick fixes and lack of awareness about proper antibiotic use are everyday choices that fuel Antimicrobial Resistance (AMR), contributing significantly to its emergence.
- Retargeting Antimicrobial Treatments - In the United States, the unnecessary prescription of antibiotics for a sore throat highlights the need for medical professionals to reconsider their approach to antibiotic prescribing, particularly when only 15% of sore throats are due to streptococcal bacteria.
- Science in Health-and-Wellness: Overcoming AMR - Scientists are pursuing innovative strategies to combat AMR, including the use of bacteriophages, developing vaccines, fecal microbiota transplant, and employing probiotics to restore gut flora.
- Medical-Conditions and AMR - AMR is not confined to bacteria; it can also occur in fungi, parasites, and viruses, affecting people with conditions like Candida, malaria, HIV, and even influenza viruses resistant to antivirals.
