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Chapter4 - Antibiotic - Resistance 2

Antibiotic resistance is a major challenge in modern medicine, resulting from the widespread use of antibiotics leading to bacterial evolution and treatment failures. The World Health Organization has identified it as a global public health threat, necessitating urgent action in surveillance and drug development. Factors such as overprescription, misuse, and inadequate infection control contribute to resistance, with significant implications for health and the economy, particularly in countries like India.

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62 views2 pages

Chapter4 - Antibiotic - Resistance 2

Antibiotic resistance is a major challenge in modern medicine, resulting from the widespread use of antibiotics leading to bacterial evolution and treatment failures. The World Health Organization has identified it as a global public health threat, necessitating urgent action in surveillance and drug development. Factors such as overprescription, misuse, and inadequate infection control contribute to resistance, with significant implications for health and the economy, particularly in countries like India.

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shadesyt4444
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© © All Rights Reserved
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Chapter 4: Antibiotic Resistance

The emergence of antibiotic resistance is one of the most significant challenges in modern
medicine. As antibiotics have become widely used in clinical, agricultural, and veterinary
settings, bacteria have evolved multiple mechanisms to evade their effects. This has led to
treatment failures, increased morbidity and mortality, and a pressing need for new
therapeutic strategies.

4.1 Definition and Importance


Antibiotic resistance refers to the ability of microorganisms to withstand the effects of an
antibiotic that once could successfully treat the infection. This resistance can be intrinsic or
acquired. Acquired resistance results from genetic mutations or horizontal gene transfer.

The World Health Organization (WHO) has declared antimicrobial resistance (AMR) a
global public health threat, emphasizing the urgent need for surveillance, stewardship, and
development of new drugs.

4.2 Mechanisms of Resistance


Bacteria can resist antibiotics through several well-documented mechanisms:

• Enzymatic Degradation: β-lactamases hydrolyze the β-lactam ring of penicillins and


cephalosporins.
• Target Modification: Mutations in bacterial ribosomal RNA or DNA gyrase reduce
antibiotic binding.
• Efflux Pumps: Specialized proteins expel antibiotics from bacterial cells, lowering
intracellular concentrations.
• Reduced Permeability: Alterations in membrane porins limit antibiotic entry.
• Biofilm Formation: Bacterial communities encased in a matrix show higher resistance due
to reduced penetration and metabolic inactivity.

4.3 Causes of Antibiotic Resistance


Several human and environmental factors contribute to the development and spread of
resistance:

• Overprescription and misuse of antibiotics.


• Incomplete antibiotic courses by patients.
• Widespread use in livestock and poultry without medical oversight.
• Poor infection control in healthcare settings.
• Lack of sanitation and access to clean water.
• Global travel and trade facilitating the spread of resistant strains.
4.4 Antibiotic Resistance in India
India faces a critical antibiotic resistance crisis due to over-the-counter availability of
antibiotics, inadequate prescription practices, and high population density. The Indian
Council of Medical Research (ICMR) has reported alarming resistance trends, especially to
commonly used antibiotics like ampicillin, ciprofloxacin, and cephalosporins.

Multi-drug resistant tuberculosis (MDR-TB) and hospital-acquired infections caused by


carbapenem-resistant Enterobacteriaceae (CRE) are of particular concern. Efforts like the
National Action Plan on AMR aim to curb misuse and promote surveillance.

4.5 Global Impact and Future Concerns


If current trends continue, common infections may once again become fatal. It is estimated
that by 2050, AMR could lead to 10 million deaths annually. Economically, this could cost
the global economy up to $100 trillion.

International cooperation is crucial to enforce stewardship, invest in new antibiotic


research, and implement stringent regulatory measures.

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