The Challenge of Antibiotic Resistance: Has our use of Antibiotics Caused more Problems than it has solved?
Antibiotics are medicines which have bactericidal or bacteriostatic properties and used in treatment or prevention of microbial diseases (NPS 2012). Antibiotics a have been in existence for a long time and were initially known as antibiosis which meant against life, and by Jean Paul Vuillemin first used this term. He used the word to describe the properties which were exhibited by the early antibacterial drugs. In 1877 Antibiosis was first described by Louis Pasteur and Robert Koch when they observed the inhibition of growth of Bacillus anthracis by an airborne bacillus. In 1928 penicillin was identified by Alexander Fleming. An American microbiologist known as Selman Waksman coined the term in 1942 (Landsberg 1949). Antibiotics work by inhibiting essential bacterial processes or structures which eventually leads to the death of the causative bacteria, for example, some antibiotics destroy the cell wall of bacteria which is essential for bacterial survival in different environments. Bacteriostatic antibiotics work by stopping bacteria from continued multiplying. In doing these the antibiotics enable the natural immune system to work on the invading bacteria and thus fight the infection. Antibiotics which have an effect on a broad range of bacteria are known as broad-spectrum, and those that affect only one or a small number of bacteria are referred to as narrow spectrum (NPS 2012).
For a long time antibiotics have proven to be reliable drugs in the treatment of various antibacterial diseases and have always be relied upon thus referred to as the ‘magic bullet.' Recently this is proving not to be the case as continued abuse or misuse of antibiotics has led to the emergence of resistant strains which are proving to be a huge concern for healthcare providers and researchers. Common antibiotics which have continuously proven reliable over the years are now not effective against microbes which they used to destroy. This has led to healthcare providers opting for a higher class of antibiotics or alternative more powerful antibiotics. There are also some setbacks when healthcare providers opt for this option because also some higher class antibiotics and those thought to be more potent antibiotics there is an emergence of resistant strains.
Over the years bacteria have been able to acquire resistance, and there are many factors which influence the bacterial resistance to an antibiotic. According to Levy (1998), there are two factors which determine bacterial resistance to antibiotics and one of the factors include the occurrence of resistant genes that eventually give rise to proteins which enable the bacteria to overcome the adverse effects of antibiotics. The second factor is the extent to which a particular antibiotic is used over time. Bacteria can acquire resistance genes through various methods. A huge number of bacteria inherit the resistance genes from their precursor or parent cells, but some bacteria also acquire resistance genes spontaneously. There are also some numerous cases where bacteria acquire resistance genes from neighboring bacterial cells. Plasmids are organelles which carry the resistance genes, but in some cases, the genes can correspondingly be found in the bacterial chromosome. Antibiotics use over time has led to bacterial resistance through various mechanisms. Overuse of antibiotics has in a huge sense contributed to an increase in chronic conditions such as type 1 diabetes, obesity, asthma, inflammatory bowel disease and allergies (Blaser 2011). An increased number of people are suffering from these conditions, and it is all related to antibiotic resistance.
According to Clemente et al. (2012), the human gut is known to have a diverse group of microorganisms which form the normal flora, and they play a vital role in ensuring the well-being of the human host. The microbiota plays roles such as metabolic functions by fermenting and later absorbing the undigested carbohydrates. The microbiota also interacts with one another plus the host’s immune system and have a direct influence on disease development. The host's immune system can recognize the microbes which are commensals through various means including receptors. Antibiotic use has a mixed effect on the gut microbiota and mostly leads to long-term effects such as the decrease in the bacterial diversity. According to Sachs and Lutz (2005), prolonged bacterial use has led to the current degree of bacterial resistance into the intestinal flora. This is because antibiotics kill the targeted harmful bacteria, but in the process also the good bacteria which form part of the natural flora are also eliminated in the process. The natural flora in some cases it doesn’t fully recover to its initial state leaving a deficit, and due to this, it has led to increased susceptibility to diseases and infections (Blaser 2011). Gut microbiota imbalance has been demonstrated to cause various infections and diseases. Restoring gut microbiota becomes essential in the management of certain diseases and it can be done through transplanting gut microbiota of foreign nature. However, the process is yet to be perfected, and further research is still ongoing (Clemente et al. 2012).
The current trend in use of antibiotics has caused more harm than good. This is because of the misuse of antibiotics which has contributed to most of the current resistant strains which are proving to be quite a challenge to manage and destroy. The present spread of bacterial resistance should be arrested before it gets worse through various mechanisms. At the farming level research should be done to come up with better alternatives to pesticides and farming chemicals which are also contributing to resistant strains of pests and when consumed the resistance is passed on to humans in the food chain. Proper cleaning of vegetables and fruits to get rid of resistant strains and antibiotic residues should be encouraged to reduce antibiotic resistance eventually. Regulating the use of antibiotics by the public and healthcare providers to prescribe antibiotics only when necessary is also another measure. The public should be educated on antibiotic use and be informed of the current situation as many are not aware of what's happening currently in the medicine world. Patients should always be encouraged to finish their dose or regimen of antibiotics even if their symptoms subside before they complete their treatment. The other role is for pharmaceutical companies which produce antibiotics to be properly regulated so as to prevent the production of substandard antibiotics which are triggering resistance in some cases. Price regulation on antibiotics should also be put in place to ensure affordable access to essential antibiotics and conventional antibiotics which have been there for a long time do not become incredibly cheap as this encourages abuse or neglect for a higher class of antibiotics.
All these measures if properly put in place will serve in reducing the upward trend in antibiotic resistance and researchers will come up with proper measures in the management of the current resistant strains. The number of chronic diseases will also reduce leading to a healthier public and society.
References
Blaser, M, 2011, ‘Stop the killing of beneficial bacteria,' Nature, vol. 476 pp 393-394.
Clemente, JC, et al., 2012, ‘The impact of the gut microbiota on human health: An integrative view,' Cell, vol. 148, pp1258-1270.
Landsberg, H, 1949, ‘Prelude to the discovery of penicillin,' Isis. 40 (3): 225–7. Doi: 10.1086/349043.
Levy, SB, 1998, ‘The challenge of antibiotic resistance,' Scientific American (March 1998) pp46- 53.
NPS Medicinewise, 2012. What are antibiotics and how do they work? Viewed 4 January 2017, from http://www.nps.org.au/medicines/infections-and-infestations/antibiotics/for-individuals/what-are-antibiotics-and-how-do-they-work.
Sachs, J and Lutz, J, 2005, ‘Are antibiotics killing us?’ Discover, vol. 26 pp1- 8.
