Introduction
The development of resistance among pathogens such as bacteria and fungi has challenged the development of safe and effective drugs. Specifically, the emergence of antibiotic-resistant bacteria due to excessive use and abuse of antibiotics in the healthcare settings and agriculture is posing a great danger to the survival of humanity.
Alanis asserts that, “indiscriminate and inappropriate use of antibiotics in outpatient clinics, hospitalized patients, and in the food industry is the single largest factor leading to antibiotic resistance” (697). The increasing resistance of bacteria to antibiotics has significantly reduced the number of antibiotics, which are safe and effective in the treatment of human diseases.
Currently, health care systems and pharmaceutical companies have noted the emergence of resistant bacteria and they have predicted the occurrence of a ‘post-antibiotic era’, if there is no discovery of new classes of antibiotics or control measures.
Therefore, this essay argues that the world is in the post-antibiotic era because the development of bacterial resistance has increased unprecedentedly and recommends enhancement of prescription in healthcare settings, control of antimicrobials in agriculture, and design of new drugs and vaccines as appropriate solutions.
The Development of Bacterial Resistance
Over the years, bacterial resistance to antibiotics has been increasing. The discovery of penicillin in 1928 was a milestone in the treatment of bacterial diseases because it was a safe and effective drug against all forms of bacteria. However, excessive use and abuse of antibiotics gradually caused the emergence of resistant strains of bacteria, which have the ability to inactivate and reduce the potency of the drug.
According to Davies and Davies, wide use of penicillin in the1930s led to the development of resistance because of the expression of penicillinase, an enzyme, which breaks the β-lactam ring of penicillin and inactivates it (418).
Likewise, the discovery of streptomycin in 1944 and its extensive use in the subsequent decades led to an increase in the resistant strains of Mycobacterium tuberculosis (Davies and Davies 419). From the use of penicillin and streptomycin, microbiologists have discovered that bacteria mutate constantly as an adaptive mechanism of surviving in the presence of antibiotics in their living environment.
The declining effectiveness of antibiotics has increased morbidity and mortality rates patients with bacterial infections over the years. Epidemiological studies indicate that multidrug resistant strains of bacteria have increased significantly in the present world because of the excessive use and abuse of antibiotics in the healthcare settings and agricultural sector (Davies and Davies 420). In the healthcare environment, nosocomial infections have increased owing to the emergence of resistant strains of bacteria.
Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae, and Salmonella enterica and gram-positive bacteria like Staphylococcus aureus have become dominant nosocomial pathogens, which increase morbidity and mortality of patients. Evidently, since the incidences of nosocomial infections have increased considerably due to the acquisition of resistance to antibiotics by bacteria, it is apparent that the era of post-antibiotics is imminent.
Bacterial resistance threatens humanity because recent incidences have occurred outside the healthcare settings. Alanis states that Streptococcus pneumoniae and group A Streptococcus have developed resistance to macrolide antibiotics and penicillin, while Staphylococcus aureus and Enterococci have developed resistance to vancomycin (698).
These bacteria have the potential of causing community-acquired infections, and thus, a threat to people in the communities that are at risk of acquiring them from the healthcare settings. According to Kassakian and Mermel, community-acquired infections such as urinary tract infections (UTI) occur due to resistant E. coli that produce extended spectrum of beta-lactamase (1). In this view, urinary tract infections are among the community-acquired infections that have the potential of destroying humanity.
The use of antibiotics in agriculture has contributed to the emergence of multidrug resistant strains of bacteria, which threatens the survival of humanity. Shea asserts that exposing microbes to antibiotics prompt them to acquire survival mechanisms by mutating their genes and becoming resistant (258). Since humans depend on agriculture to produce food and the use of antimicrobials is necessary, bacteria constantly mutate to adapt various environments owing to their exposure to antibiotics.
Evidently, indiscriminate use of antibiotics in agriculture hastens the rate of mutation among bacteria and contributes to the emergence of virulent strains of bacteria, which are resistant to present antibiotics, and thus, pose a great threat to the survival of humanity. Hence, indiscriminate use of antibiotics in the agriculture has led the world to post-antibiotic era, which the health care systems are currently grappling to overcome.
Across the world, the health care systems are experiencing an increased challenge in the treatment of bacterial infections owing to the enhanced resistance to antibiotics. Centers for Disease Control and Prevention indicates that penicillin, tetracycline, erythromycin, methicillin, gentamycin, imipenem, ceftazidine, levofloxacin, linezolid, daptomycin, and cetftaroline are antibiotics, which different forms of bacteria have developed resistance to since the 1940s (28).
The observed trend is that the excessive use and abuse of antibiotics have led to the emergence of resistant strains of bacteria. Moreover, the available antibiotics are declining with time because pharmaceutical companies find it expensive to design and produce because they will not last in the market for a decade and give expected returns (Davies and Davies 425). Therefore, it is predictable that the world is in the post-antibiotic era because the populations continue to use and abuse antibiotics in and out of the healthcare settings.
Solution to Bacterial Resistance
Since bacterial resistance emanate from the abuse of antibiotics in the healthcare settings and among individuals, effective control is necessary. According to Centers for Disease Control and Prevention, regulation of antibiotics through prescription is essential in reducing their indiscriminate use in the health care system and among the populations (31). A significant number of antibiotics that humans consume daily are unnecessary and appropriate, and thus, their removal from the population is crucial to prevent abuse.
In essence, prescription is an effective solution, which reduces accessibility of antibiotics to individuals, who are likely to abuse. Healthcare providers should only prescribe antibiotics to treat specific disease and administer them appropriately in terms of route and dosage. Therefore, the health care system in conjunction with pharmaceutical companies needs to adopt legislations that govern the use of antibiotics among patients and general populations.
Indiscriminate use of antimicrobials in agriculture has led to the development of mutant microbes, which are highly resistant to antibiotics. Shea recommends farmers to use antimicrobials judiciously in controlling development strains of bacteria, which are resistant to antibiotics (253).
Fundamentally, indiscriminate use of antibiotics in agriculture exposes native strains of bacteria to novel chemicals and prompts them to mutate their genes so that they can adapt to the changing environment in which they live. Hence, agricultural sector needs to check the nature of antimicrobials that it uses and assesses the impacts on the development of microbial resistance before using them in food production.
Design and development of new drugs is also an effective solution that would reverse the increasing resistance of bacteria to antibiotics. Centers for Disease Control and Prevention recommends researchers to keep in tandem with the mutation patterns and trends of bacteria, which are evolutionary mechanisms of surviving harsh environments that they live, in designing and developing antibiotics (31).
To design and develop effective antibiotics, pharmacologists need to understand survival mechanisms of bacteria and track their spread across the globe to contain their spread and prevent catastrophic events related to resistance and infections. Production of new vaccines and antibiotics are major approaches that health care systems can effectively apply to suppress the spread of resistant strains of bacteria from one population to another (Centers for Disease Control and Prevention 33). Thus, pharmacologists should design new antibiotics and vaccines periodically in response to the trends of resistance among bacteria.
Conclusion
The increasing incidences of resistance among bacteria across the decades since 1930s show that the current world is on the verge of post-antibiotic era. Since different classes of antibiotics are no longer effective as they used to be during their discovery period, the health care systems have minimal choices of antibiotics, which they can use in treating and preventing diverse forms of bacteria.
Since 1930s, drugs such as penicillin, tetracycline, erythromycin, methicillin, gentamycin, levofloxacin, linezolid, daptomycin, and cetftaroline amongst others are no longer effective against harmful bacteria. Hence, the world is gradually heading to a post-antibiotic era, if the health care system does not put in place necessary interventions to reverse the trends of bacterial resistance.
As solutions to the bacterial resistance, prescription of antibiotics in healthcare settings and judicious use of antimicrobials in agriculture are essential to prevent indiscriminate use of antibiotics. Moreover, design and production of new drugs and vaccines is essential to keep in tandem with the evolution of bacteria.
Works Cited
Alanis, Alfonso. “Resistance to Antibiotics: Are We in the Post-Antibiotic Era.” Archives of Medical Research 36.6 (2005): 697-705. Print.
Davies, Julian, and Dorothy Davies. “Origin and Evolution of Antibiotic Resistance.” Microbiology and Molecular Biology Reviews 74.3 (2010): 417-433. Print.
Centers for Disease Control and Prevention. Antibiotics resistance threats in the United States. 2013.
Kassakian, Steven, and Leonard Mermel. “Changing epidemiology of infections due to extended spectrum beta-lactamase producing bacteria.” Antimicrobial Resistance and Infection Control 3.9 (2014): 1-6. Print.
Shea, Kevin. “Antibiotic resistance: What is the impact of agricultural uses of antibiotics on children’s health?” Pediatrics 112.2 (2003): 253-258. Print.