The most crucial problem of medical or any other use of antibiotics is the possibility and almost even the inevitability of the emergence of resistance to all classes of these substances. Of particular danger is the occurrence and rapid spread of pathogenic microorganisms observed in the last decade, which have become multi-resistant. A warning has appeared among the medical community that antimicrobial resistance is a serious problem that undermines efforts to combat infectious diseases and could potentially halt progress, and possibly even reverse it. This problem is being intensively studied at present in connection with the high theoretical and practical significance of these problems. This essay discusses the importance of susceptibility tests in the prevention and treatment of infectious diseases and analyzes the reasons why microorganisms exhibit resistance to antimicrobial substances.
Sensitivity tests determine the resistance of the microbe to antibacterial drugs by exposing it to standardized concentrations of those substances. Sensitivity analysis can be carried out for bacteria, fungi, and viruses. For some organisms, the results from a single drug predict the outcomes for other similar drugs. Thus, not all potentially active drugs are tested. The sensitivity analysis is carried out in vitro and, possibly, does not take into account many factors of natural conditions (for example, pharmacodynamics and pharmacokinetics, the peculiarity of the concentration of the drug in specific tissues and organs, the human body immunity), which eventually affect the success of treatment. Thus, the results of sensitivity tests do not always predict the outcome of treatment.
When antibiotics began to be used in the 1940s, they were called a miracle cure. But now there are fears that due to their too frequent use, bacteria have developed resistance to drugs. Antimicrobial resistance (AMR) is the ability of a microorganism to transfer significantly higher concentrations of the drug than other microorganisms of a given strain. Long-term accumulation of adaptations to survive drug exposure can lead to the development of AMR (Lomazzi, M. et al., 2019). Resistant microbes are increasingly harder to treat, requiring alternative medications or higher doses of drugs, which can be more expensive, more toxic, or both. They survive the treatment and multiply, passing their genes to the offspring, which is why the effectiveness of medications is further reduced. Resistance can occur spontaneously due to random mutations. The role of antimicrobial use in driving the emergence of resistance is likely to be specific to each drug and each microorganism, as is the effect of changes in this use (Holmes, A. et al., 2015). However, the increased and irrational use of antimicrobials appears to stimulate the release of mutations that may render antimicrobials ineffective and therefore increase in antibiotic resistance. At the moment, other existing types of antibiotics may come to the rescue, but gradually there are fewer options now, as bacteria adapt and develop resistance to numerous medications.
There is an urgent need to ensure that professionals strictly follow the protocols of disease management and that patients follow the doctor’s instructions and do not self-medicate. Additionally, it is necessary to raise the level of awareness of this issue among medical workers, parents, society as a whole, and especially the media. Therefore, it is important that health organizations in different countries urge doctors and patients to stop abusing antibiotics.Humanity has gone through various stages of the evolution of attitudes towards antibiotics – from cautious rejection to total abuse. However, all that people need is reasonable sufficiency.
References
Holmes, A., Moore, L., Sundsfjord, A., Steinbakk, M., Regmi, S., & Karkey, A. (2015). Understanding the mechanisms and drivers of antimicrobial resistance. Series, 1–12.
Lomazzi, M., Moore, M., Johnson, A., Balasegaram, M., & Borisch, B. (2019). Antimicrobial resistance – moving forward? BMC Public Health, 19(1).