What are antibiotics, antibiotic resistance?

Antibiotics are medicines used to prevent and treat bacterial infections. Antibiotic resistance occurs when bacteria change in response to the use of these medicines.

Antibiotic resistance Also known as antimicrobial resistance, it refers to the resistance of a microbe to a medication that used to be an effective treatment

Antibiotic resistance is a worldwide problem. New forms of antibiotic resistance can cross international boundaries spreading between continents with ease. Many forms of resistance spread with remarkable speed. World health leaders have described antibiotic-resistant microorganisms as “nightmare bacteria” that “pose a catastrophic threat” to people in every country in the world.

The purpose of this article is to increase awareness of the threat that antibiotic resistance poses and to encourage immediate action to address the threat. 

History (ref: phenomenology of biocastrophe publication vol. 4)

According to a study conducted in the year 2013, each year in the United States, at least 2 million people acquire serious infections with bacteria that are resistant to one or more of the antibiotics designed to treat those infections. At least 23,000 people die each year as a direct result of these antibiotic-resistant infections. Many more die from other conditions that were complicated by an antibiotic-resistant infection. In addition, almost 250,000 people each year require hospital care for Clostridium difficile (C. difficile infections. In most of these infections, the use of antibiotics was a major contributing factor leading to the illness. At least 14,000 people die each year in the United States from C. difficile infections. Many of these infections could have been prevented. Antibiotic-resistant infections add considerable and avoidable costs to the already overburdened U.S. healthcare system. In most cases, antibiotic-resistant infections require prolonged and/or costlier treatments, extend hospital stays, necessitate additional doctor visits and healthcare use, and result in greater disability and death compared with infections that are easily treatable with antibiotics. The total economic cost of antibiotic resistance to the U.S. economy has been difficult to calculate. Estimates vary but have ranged as high as $20 billion in excess direct healthcare costs, with additional costs to society for lost productivity as high as $35 billion a year (2008 dollars).

Factors that lead to antibiotic resistance

The use of antibiotics

The use of antibiotics is the single most important factor leading to antibiotic resistance around the world. Antibiotics are among the most commonly prescribed drugs used in human medicine. However, up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed. Antibiotics are also commonly used in food animals to prevent, control, and treat disease, and to promote the growth of food-producing animals. The use of antibiotics for promoting growth is not necessary, and the practice should be phased out.

It is difficult to directly compare the amount of drugs used in food animals

with the amount used in humans, but there is evidence that more antibiotics are used in food production. 

spread of the resistant strains of bacteria 

The other major factor in the growth of antibiotic resistance is spread of the resistant strains of bacteria from person to person, or from the non-human sources in the environment, including food. 

There are four core actions that will help fight these deadly infections:    

  1. Preventing infections and preventing the spread of resistance 
  2. Tracking resistant bacteria  
  3. Improving the use of today’s antibiotics  
  4. Promoting the development of new antibiotics and developing new diagnostic tests for resistant bacteria.

Bacteria will inevitably find ways of resisting the antibiotics we develop, which is why aggressive action is needed now to keep new resistance from developing and to prevent the resistance that already exists from spreading.   

Estimated minimum number of illnesses and deaths caused by antibiotic resistance, including bacteria and fungus: At least 2,049,442 illnesses and 23,000 deaths  

Estimated minimum number of illnesses and death due to Clostridium difficile (C. difficile), a unique bacterial infection that, although not significantly resistant to the drugs used to treat it, is directly related to antibiotic use and resistance: At least 250,000 illnesses and 14,000 deaths. 

Where do infections happen?  

Antibiotic-resistant infections can happen anywhere. Data show that most happen in the general community; however, most deaths related to antibiotic resistance happen in healthcare settings, such as hospitals and nursing homes. 

Antimicrobial resistance is one of our most serious health threats. Infections from resistant bacteria are now too common, and some pathogens have even become resistant to multiple types or classes of antibiotics (antimicrobials used to treat bacterial infections).The loss of effective antibiotics will undermine our ability to fight infectious diseases and manage the infectious complications common in vulnerable patients undergoing chemotherapy for cancer, dialysis for renal failure, and surgery, especially organ transplantation, for which the ability to treat secondary infections is crucial. When first-line and then second-line antibiotic treatment options are limited by resistance or are unavailable, healthcare providers are forced to use antibiotics that may be more toxic to the patient and frequently more expensive and less effective. Even when alternative treatments exist, research has shown that patients with resistant infections are often much more likely to die, and survivors have significantly longer hospital stays, delayed recuperation, and long-term disability.

Efforts to prevent such threats build on the foundation of proven public health strategies:

  • Immunization,
  • Infection control, 
  • Protecting the food supply, 
  • Antibiotic stewardship, and 
  • Reducing person-to-person spread through screening, treatment and education.  

How antibiotic resistances happen?

  1. Exposure to germs(a few are drug resistant)
  2. Antibiotics kill bacteria causing illness as well as good bacteria that  protect the body from infections.
  3. The drug resistance bacteria are now capable of growing hence taking over.
  4. Some bacteria pass their drug resistance to other bacteria causing more  problems.

People at High Risk 

As antibiotic resistance grows, the antibiotics used to treat infections do not work as well or at all. The loss of effective antibiotic treatments will not only cripple the ability to fight routine infectious diseases but will also undermine treatment of infectious complications in patients with other diseases.

Many of the advances in medical treatment—joint replacements, organ transplants, cancer therapy, and treatment of chronic diseases such as diabetes, asthma, rheumatoid arthritis—are dependent on the ability to fight infections with antibiotics. If that ability is lost, the ability to safely offer people many life-saving and life-improving modern medical advantages will be lost with it.

For example:   

1. Cancer chemotherapy

2. Complex surgery

3. Rheumatoid arthritis

4. Dialysis for end-stage renal disease

5. Organ and bone marrow transplant.

Facts about antibiotics

  • Antibiotics are powerful drugs that are generally safe and very helpful in fighting disease, but there are times when antibiotics can actually be harmful.
  •  Antibiotics can have side effects, including allergic reactions and a potentially deadly diarrhea caused by the bacteria Clostridium difficile (C. difficile).
  • Antibiotics can also interfere with the action of other drugs a patient may be taking for another condition. These unintended reactions to antibiotics are called adverse drug events.
  • When someone takes an antibiotic that they do not need, they are needlessly exposed to the side effects of the drug and do not get any benefit from it.
  • Moreover, taking an antibiotic when it is not needed can lead to the development of antibiotic resistance. When resistance develops, antibiotics may not be able to stop future infections. Every time someone takes an antibiotic they don’t need, they increase their risk of developing a resistant infection in the future. 

Actions to prevent antibiotic resistance

  1. Preventing infections as well as the spread of the resistance by: immunization, safe food preparation, hand washing and using antibiotics as directed and when need be.

  1. Tracking-experts can develop strategies to prevent infections and the  spread of the resistant bacteria.
  2. Improving antibiotic stewardship.
  3. Developing new drugs and diagnosis tests.