Antibiotic resistance: a new pandemic threat of the 21st century

Dr Satyawan Saurabh *

To prevent and control the spread of antibiotic resistance, individuals should only use antibiotics when prescribed by a certified health professional. Never ask for antibiotics if your health worker says you do not need them. Always follow your health worker's advice when using antibiotics. Never share or use leftover antibiotics. Do not use antibiotics to promote growth or prevent diseases in healthy animals. Vaccinate animals to reduce the need for antibiotics and use alternatives to antibiotics when available. Promote and implement good practices at all stages of production and processing of foods from animal and plant sources. Improve biosecurity on farms and prevent infections through improved hygiene and animal welfare.

The World Health Organization (WHO) released the top 10 threats to global health, of which antimicrobial resistance (AR) is a huge contributor, with 1.6 million deaths every year caused by the tuberculosis drug-resistant microbe.

The study "Understanding the drivers of antibiotic resistance genes in high Arctic soil ecosystems" by the journal Environment International shows that a total of 131 antibiotic-resistant gene (ARG) materials were detected, of which the Blendum-1 gene, which was first detected in surface water in India in 2008, has spread across the Arctic in just 11 years.

This shows that antibiotic resistance is a new pandemic threat of the 21st century. It is no longer a local problem and should be seen as a global health concern. A report titled "Anti-microbial Resistance Benchmarks" states that 700,000 deaths occur worldwide annually due to AR bacteria.

India has witnessed a rise in antibiotic consumption – about 65 percent in 2015 compared to 2000, while the rate of consumption has increased from 3.2 to 6.5 billion daily prescribed doses (DDD) in the same period.

Microorganisms can become resistant to drugs due to both biological and social reasons. As soon as scientists introduce a new antimicrobial drug, there is a good chance that it will become ineffective at some point in time. This is mainly due to changes that occur within the microorganisms. These changes can occur in various ways. When microorganisms reproduce, genetic mutations can occur.

Sometimes, this will create a microorganism with genes that help it survive in the face of antimicrobial agents. The microorganisms carrying these resistant genes survive and replicate. The newly generated resistant microorganisms inherit the genes from their parents and eventually become the dominant type.

Microorganisms can inherit genes from other microorganisms. Genes that confer drug resistance can easily be transferred between microorganisms.

Microorganisms can change some of their characteristics to become resistant to common antimicrobial agents. This occurs in environments with already resistant microorganisms. Non-adherence to recommendations for the use of certain drugs can increase the risk of antimicrobial resistance. The way people use antimicrobial drugs is an important contributing factor.

Some subjective reasons include that doctors sometimes prescribe antimicrobial drugs "just in case," or they prescribe broad-spectrum antimicrobial drugs when a specific drug is more appropriate. Using these drugs in this way increases the risk of antimicrobial resistance. If a person does not complete a course of antimicrobial drugs, some germs may survive and develop resistance to the drug.

Resistance can also develop when people use drugs for conditions they cannot treat. For example, people sometimes take antibiotics for viral infections. Also, antibiotics prescribed by quacks or pharmacists contribute to increasing this issue.

The use of antibiotics in farm animals can promote drug resistance. Scientists have found drug-resistant bacteria in meat and food crops that come into contact with fertilizers or contaminated water. In this way, diseases that affect animals can spread to humans. People who are seriously ill are often given high doses of antimicrobial drugs.

This promotes the spread of AMR microorganisms, especially in environments where a variety of diseases are present. Antibiotic resistance is accelerated by the misuse and overuse of antibiotics, as well as a lack of infection prevention and control. Steps can be taken at all levels of society to reduce the impact of resistance and limit its spread.

To prevent and control the spread of antibiotic resistance, individuals should only use antibiotics when prescribed by a certified health professional. Never ask for antibiotics if your health worker says you do not need them. Always follow your health worker's advice when using antibiotics. Never share or use leftover antibiotics.

Prevent infection by washing hands regularly, preparing food hygienically, avoiding close contact with sick people, practicing safe sex, and keeping vaccinations up to date. Prepare food hygienically following the (WHO) five keys to safe food (keep clean, separate raw and cooked, cook thoroughly, store food at safe temperatures, use safe water and raw materials) and choose foods produced without the use of antibiotics to promote growth or prevent disease in healthy animals.

To prevent and control the spread of antibiotic resistance, policymakers should ensure that a strong national action plan to tackle antibiotic resistance is in place. Improve surveillance of antibiotic-resistant infections. Strengthen policies, programs, and implementation of infection prevention and control measures. Regulate and promote the proper use and disposal of quality medicines.

Make information available about the impact of antibiotic resistance. To prevent and control the spread of antibiotic resistance, healthcare professionals should prevent infections by ensuring that their hands, equipment and environment are clean. Prescribe antibiotics only when they are needed, according to current guidelines. Report antibiotic-resistant infections to surveillance teams.

Talk to your patients about how to take antibiotics correctly, the dangers of antibiotic resistance and misuse. Talk to your patients about preventing infections (for example, vaccination, hand washing, safe sex and covering the nose and mouth when sneezing).

To prevent and control the spread of antibiotic resistance, the healthcare industry should invest in research and development of new antibiotics, vaccines, diagnostics and other tools. To prevent and control the spread of antibiotic resistance, the agricultural sector should only give antibiotics to animals under veterinary supervision. Do not use antibiotics to promote growth or prevent diseases in healthy animals.

Vaccinate animals to reduce the need for antibiotics and use alternatives to antibiotics when available. Promote and implement good practices at all stages of production and processing of foods from animal and plant sources. Improve biosecurity on farms and prevent infections through improved hygiene and animal welfare.

Antimicrobial resistance needs to be addressed urgently from a human, animal and environmental health perspective. All countries need to work together to limit the spread of ARGs and antibiotics among humans, animals and the environment in the global world we live in. Although national action plans have been developed by most countries, these plans are yet to move from paper to ground as antibiotics continue to be freely used.