Understanding Antibiotic Resistance: Causes, Consequences, and Solutions

Introduction

This paper will explore the issue of antibiotic resistance. It will also provide a brief discussion of different types of antimicrobials and their influence on the creation of superbugs.

Overview of the Issue

Antibiotics are the type of drugs designed to treat bacterial infections. Even though they are fairly effective against bacteria, they cannot fight viral infections such as flu, common cold, and sore throats, among others (1). Antibiotics are known as antimicrobial agents and are being widely used for more than 70 years (2). They have been developed in the early 1940s and have helped to significantly reduce mortality rates from infectious diseases (2).

Antibiotic resistance occurs when a microorganism develops the ability to stop the effect of antimicrobials (3). The growing rates of antibiotic resistance is a major challenge for public health (4). When a person gets infected with a bacterium that is resistant to the effect of antibiotics, the task of treatment of such a person becomes significantly complicated (4). According to Centers for Disease Control and Prevention (CDC), around 23,000 people in the United States are getting killed by various types of bacteria each year (2).

The findings from the World Health Organization (WHO) suggest that around US$ 1.5 billion each year is spent on the treatment of the various diseases caused by the drug-resistant bacteria (5). Moreover, a longer hospital stay can result in significant productivity losses (5).

Causes of Antimicrobial Resistance

There are several major causes of antimicrobial resistance: selective pressure, mutation, gene transfer, societal pressures, inappropriate use, hospital use, agricultural use, and inadequate diagnosis (6). Gene transfer is the process of exchange of small genome pieces between different bacteria (6). The general use of antibiotics leads to selective pressure for single-celled microbes. Even though it is the main contributor to the problem of antimicrobial resistance, there are other social pressures that can help microbes to adapt to new environmental challenges (6).

Inappropriate use of antimicrobials significantly accelerates the rates of natural selection of resistant bacteria. It is often a result of prescription drugs for the treatment of undiagnosed infection in emergency cases (6). The heavy use of a wide range of antibiotics in clinical settings can also contribute to the problem of bacteria resistance (6). The practice of treating animals with antibiotics is another major cause of accelerated selection of resistant bacteria. According to NIAID, approximately half of all American antimicrobials are being produced for the needs of animal husbandry (6).

Narrow-Spectrum and Broad-Spectrum Antibiotics

All antimicrobials can be roughly divided into two categories according to the range of bacterial targets susceptible to their effect. Those are narrow-spectrum and broad-spectrum antibiotics (7). Narrow-spectrum antibiotics prove useful in the treatment of only one particular group of bacteria. Broad-spectrum antibiotics, on the other hand, are effective against a wide spectrum of microorganisms (7).

Due to the lack of precise definition, those two terms have been used incorrectly since the year of their first mentioning in 1950 (7). Narrow-spectrum antibiotics are associated with the targeted treatment of the disease when its specific causal agent has been precisely defined. The main disadvantage of this group of antimicrobials lies in their very nature, namely, their disability to fight various kinds of bacteria (7).

Therefore, they cannot be used when infecting bacteria have not been identified. However, due to its limited effectiveness range, narrow-spectrum antibiotics do not eliminate resident nonpathogenic bacteria present in the patient’s body, thus causing them less harm (7). Moreover, the use of this kind of antibiotics is associated with lower chances of developing superinfection. Another obvious advantage of narrow-spectrum antibiotics is that they do not contribute to the natural selection of resistant bacteria (7).

Broad-spectrum antimicrobials are used for the treatment of a broad range of infectious bacterium. They are effective against both gram-positive and gram-negative infections (7). The use of broad-spectrum antibiotics can be justified in the case when there is a bigger threat to the life of a seriously ill patient than a potential danger of superinfection (7). It can also be utilized in combination with other antimicrobial therapy to manage already developed superinfection. Broad-spectrum antibiotics can be properly used in the medical scenario where the infectious agent does not respond to the effect of narrow-spectrum antibiotics (7).

Superbugs

Superbug is an informal term for a type of bacteria that has developed resistance to several kinds of antimicrobials. According to the CDC, 23,000 people in the United States are getting killed by various types of superbugs each year (2). More than 200 people have been exposed to carbapenem-resistant Enterobacteriaceae in one of the Los-Angeles hospitals in 2015 (8). It is the usual way the superbugs infection spreads. There was also a threat of an outbreak of E. coli—a strain of bacteria resistant to carbapenem and other antibiotics (8). In order to reduce the spread of drug-resistant bacteria, a set of measures by the United States government, CDC, and WHO has to be taken.

References

1. FDA. Antibiotic and Antibiotic Resistance. Web.
2. CDC. Antibiotics/Antimicrobial Resistance. Web.
3. CDC. About Antimicrobial Resistance. Web.
4. FDA. Antimicrobial Resistance. Web.
5. WHO. Antibiotic Resistance. Web.
6. NIAID. Antimicrobial (Drug) Resistance Causes. Web.
7. Bhattacharjee, M. Chemistry of Antibiotics And Related Drugs, Springer-Verlag: New York, 2016; pp 7-9.
8. WebMD. Superbugs: What They Are and How You Get Them. Web.