Antibiotic resistance is a worldwide threat that occurs when bacteria adapt in response to the use of antibiotics. A growing number of infections are becoming difficult to treat as antibiotics are becoming less effective. In this review, we shall understand how healthcare providers and patients can combat antibiotic resistance, and reduce the misuse of these medicines and the role of prescriptions.
While the causes of this pandemic are complex, the effects are simple: we need to change how we use antibiotics. These medicines save lives and make us healthier, but if left in the wrong hands, they can become a danger to us all in hospitals, nursing homes, and in our homes. Antibiotic resistance is something we must all see as a global problem and act together to solve.
The World Health Organization (WHO) estimates that without changes in human behavior, antibiotic-resistant bacteria will become an even greater threat in the future. Antibiotics remain the treatment of choice for many infections, and they can be lifesaving.
Antibiotic-resistant bacteria emerge as a result of antibiotics being used incorrectly or too often which causes serious illnesses and even death.
We as a society need to take certain steps to reduce and limit the impact of antibiotic resistance. Some of the steps that we can take at an individual level are as follows:1
- Using prescribed antibiotics only
- Never demanding antibiotics, never sharing the leftover antibiotics from a patient
- Washing hands, practicing safer sex, regular vaccinations, hygienic food preparations can prevent infections
- WHO recommends food safety by choosing foods that are organic and healthy produced without the use of antibiotics1
Antibiotic resistance is an important cause for concern as it can endanger the survival of patients. The emergence of antibiotic resistance happens for different reasons - some of them are overuse, lack of research and education, improper use, and contamination.1 To prevent its spread, you
have to reduce your consumption patterns, understand the reason behind different resistance patterns and know how to keep yourself safe from infection.
A study predicted that approximately 30% of oral antibiotic prescriptions in the US were inappropriately prescribed to patients.2 Medical procedures lose their effectiveness when antibiotics no longer perform their expected functions. Patients experience treatment failure, longer hospital stays, expensive drugs, and stress. Antibiotic resistance has a role in the economy as well; it delays the number of individuals that can return to the workforce, leading to increased mortality and morbidity.2
What is antibiotic resistance?
Antibiotic resistance refers to the ability of bacteria to resist one or more antibiotics by developing mechanisms that prevent, inhibit, or impede the action of the antibiotics. The main routes of resistance development involve modifications of the antibiotic molecule or target sites and global cellular responses.3 For example, a urinary tract infection (UTI) cause by antibiotic resistant bacteria can no longer be killed by common antibiotics. This makes the UTI more difficult to treat and can lead to complications.
Ways to prevent antibiotic resistance
- Promotion of awareness of all the stakeholders: World Antibiotic Awareness Week aims at promoting awareness around antibiotic resistance and encouraging best practices
- Containment of bacterial transmission and prevention of infection: Adopting the highest levels of sterile practices in a healthcare facility to prevent the spread of any type of infection
- Surveillance of healthcare-associated infections and antibiotic resistance: This helps in identifying the magnitude of the problem and factors affecting the infection
- Antibiotic stewardship: Antimicrobial Stewardship Programs can help optimise the treatment of patients with infections, reduce adverse events associated with antibiotic use, and improve healthcare outcomes
- Education for changing behavior
Causes, symptoms and treatment
Causes of antibiotic resistance
The inappropriate use of antibiotics and poor hygiene are contributing factors to the development of antimicrobial resistance. Our actions as a society directly affect the health professionals we trust with our healthcare, and our use of antibiotics.
Inappropriate antibiotic use leads to bacterial resistance, meaning that we will not be able to kill them with antibiotics when we next need to use them. If we raise awareness of this issue so that patients also take action, doctors can learn that it is time to approach treatments differently without resorting immediately to antibiotics. In this way, mortality will be reduced and antibiotic development can continue unhindered.
Symptoms of antibiotic resistance
Antibiotics can help treat many kinds of infections and are on hand in most hospitals. But if you develop an antibiotic-resistant infection and don't respond to the standard antibiotics, you may need clinic-based treatments or a hospital stay. Your healthcare provider will likely take a sample of your infected tissue and send it to a lab. Once the type of infection is figured out, tests can predict which antibiotics will kill the germs. You may have an antibiotic-resistant infection if you don't get better after treatment with standard antibiotics.
Treatment for antibiotic resistance
Normal human microbiota act as a barrier against colonisation by pathogenic microorganisms. Using antimicrobials in a manner that minimises disturbance to the normal flora reduces the risk of emergence and spread of resistant strains between patients and the transfer of resistant genes between microorganisms. This reduces the risk of developing new antimicrobial-resistant bacteria in healthcare settings
Who is at risk of antibiotic resistance?
The more antibiotics you take, the greater your chances of developing antibiotic resistance. People with asthma and chronic obstructive pulmonary disease may be at greater risk of developing antibiotic-resistant organisms (common colds). People with HIV infection should avoid penicillin and erythromycin. Organ transplant recipients are at particular risk of developing antibiotic-resistant bacteria because they are often given high doses of antibiotics during their hospital stay.
How is antibiotic resistance diagnosed?
Antibiotic-resistant infections are becoming more of a problem worldwide due to the overuse and misuse of antibiotics. We don’t know what type of bacteria is causing an infection until we treat someone. At that point, we are also aware that the resistant bacteria have become immune to treatment with medication designed specifically for that disease. Treatment options may be limited by this new resistance problem and our ability to cure and prevent infection can become compromised.
Antibiotic resistance is happening across the world. More bacteria have become resistant with increasing use of antibiotics. Antibiotics are only to be used by prescription, and should not be abused. Preventing infections and their spread, good hygiene can help stop antibiotic resistance by reducing the need for them.
- Soothill G, Hu Y, Coates A. Can we prevent antimicrobial resistance by using antimicrobials better?. Pathogens. 2013 Jun 10;2(2):422-35.
- Leal JR, Conly J, Henderson EA, Manns BJ. How externalities impact an evaluation of strategies to prevent antimicrobial resistance in health care organizations. Antimicrobial Resistance & Infection Control. 2017 Dec;6(1):1-1.
- de Angelis C, Nardone A, Garifalos F, Pivonello C, Sansone A, Conforti A, et al. Smoke, alcohol and drug addiction and female fertility. Reprod Biol Endocrinol [Internet]. 2020 Dec [cited 2022 Nov 26];18(1):21. Available from: https://rbej.biomedcentral.com/articles/10.1186/s12958-020-0567-7