Antimicrobial Resistance and How it's Threatening Us?

Alexander Fleming, a professor of bacteriology, isolated penicillin from mold juice in 1928. Then after nearly twenty years of experiments, scientists might finally manufacture pure penicillin commercially. Allied force widely used it in World War II. It was a lifesaving drug for them throughout the war. However, in recent years, we are facing the opposite kind of problem. Once used for the benefit of humanity, these drugs are currently turning into a threat to billions of lives around the globe.

What is Antimicrobial resistance? (AMR)

Antimicrobial Resistance (AMR) is a method of developing a defense mechanism of the pathogens against antimicrobial medicines. Mutation: Genetic mutation can occur while microbes reproduce. Sometimes, this may produce a microbe with genes that facilitate its survival in the face of antimicrobial agents. Pathogens evolve in some way to survive, grow and spread their resistance. Additional use of antimicrobials results in more adaptation against the medicine. That's why Antibiotics and antimicrobial drugs aren't acting expeditiously on the patients, and it's turning more difficult or not possible to treat patients with infections.

What's the difference between Antibiotic resistance and Antimicrobial resistance?

To perceive and deliver the message to the mass folks, these terms are usually used. However, Antimicrobials are the medicines used against microbes (i.e., Bacteria, Viruses, Fungus, parasites, etc.) On the opposite hand, Antibiotics are the medicines used against the sole bacterium.

Why could Antimicrobial Resistance (AMR) be an international threat? 

According to the World Health Organization (WHO), fighting against Antimicrobial Resistance (AMR) is the greatest challenge for the world. The rapid drug resistance rate is so dreadful. For this reason, it's turning troublesome to treat common infections today. AMR is a curse for the approaching generation. Individuals of any age from any country can be affected by the fatal result of AMR. On April 30, 2014, the 1st international report by WHO on AMR showed a severe worldwide threat to public health 1. Infection by the 'Superbugs' with the potential to spread across the borders isn't treatable by the medicines currently accessible within the market. In 2013, about half a million cases of multidrug-resistant TB were reported by World Health Organization. It's 20% more than the previously treatable cases. Annually, about 2.8 million individuals are infected by resistant pathogens in the U.S. About 9.8% of them die as a result of resistance. Nobody can utterly avoid the risk of resistance. However, some individuals are at more considerable risk than others (i.e., chronic illnesses). We'll lose the flexibility to treat the infectious disease if antibiotics don't seem to be as effective as before.

Some diseases are treated using antimicrobials, including chronic diseases like diabetes, asthma, and rheumatoid arthritis.

Misuse of antimicrobials:

• Many physicians prescribe broad-spectrum antibiotics. It might be appropriate to use a specific drug, which is one of the leading causes of developing AMR.
• People often aren't careful regarding completing the entire course of antibiotics. They tend to stop medication whenever they feel better. One will feel better once the microorganism load is very low. However, some microorganism can still be within him and is capable of developing resistance to the drug.
• Resistance may occur if antibiotics are not used for the particular treatment. More often, it's seen to take antibiotics in viral infections.
• In farm animals, the owner tends to administer broad-spectrum antibiotics randomly. This can potentially end up in AMR in both humans and animals.
• Another typical example is, people have been prescribed antibiotics for sore throat. However, only a minor portion (about 10%) of sore throat is caused by bacterial infections, which should be treated with antibiotics.
• According to Food and Drug Administration, every year, about ten million individuals have been prescribed antibiotics that are of no use.

AMR will cause the subsequent issues:

• Increases the probability of death.
• More complicated illness.
• More doctor visits.
• Use of more powerful and more expensive drugs.
• Economic loss because of illness.
• Stay in the hospital for an extended time.
• Increases the prospect of spreading disease.

List of diseases that has an impact on AMR:

• Tuberculosis (TB): standard antibiotic treatment isn't working against TB.
• E. Coli infection: Resistance of this bacteria is increasing rapidly.
• Methicillin-resistant staphylococcus aureus (MRSA): changing into fateful day by day because of resistance.
• Malaria: particular anti-parasitic drug is currently ineffective.
• GonorrheaFungal Infections: Aspergillus, Candida, etc.

Preventive Measures to fight AMR:

• Avoid Infections in the first place. 
• Wash your hand using a block of soap or alcohol-based hand gel. This is a simple measure to avoid infections. Many bacteria spread from one individual to another by hand.
• Get vaccinated. Vaccination provides immunity against infectious diseases like Measles, Whooping cough, Mumps, Chickenpox, etc. 
• Take antibiotics as prescribed by the doctor. It's essential to take the antibiotics as prescribed. One shouldn't stop taking medicine even if he's feeling better. This might lead to antibiotic resistance of the bacteria. 
• Do not skip doses. This hurts the duration of treatment.
• Complete the entire course of antibiotics. For most infections, it is suggested to complete a whole course of antibiotics to avoid Antimicrobial Resistance. If any doubt, talk to your physician immediately.

Sakib Anzum Pranto

Doctor of Veterinary Medicine,

Bangladesh Agricultural University