Antibiotic Resistance -Die before being killed.

Introduction
To understand antibuotic resistance let me first make you familiar with basic concepts related to the topic so as to understand the whole topic eaaily. Let us begin by defnitions

ANTINIOTIC :-Antibiotics are the substances used to prevent and treat bacterial infections.

RESISTANCE:- It means that the infections are no longer prevented or cured by those drugs which were previously controlling these bacteria.

 CAUSES OF RESISTANCE

OVERUSE OF ANTIBIOTICS:-The overuse of antibiotics clearly drives the evolution of resistance.How?
Due to overuse of antibiotics bacteria try to follow "SURVIVAL OF THE FITTEST* rule.Those bacteria which are prone are killed, leaving behind population of resistant bacteria which are well adapted to antibiotic replete environment.These adaptations are brought over by mutuations in bacterial genes.Due to mutuationa bacteria achieve some notorious features like
(1)They become impermeable to drugs.
(2)they efflux the drug rapidly if absorbed
(3)may develop drug destroying enzymes etc

*How is overuse possible?

In many countries antibiotics are unregulated and available over the counter without a prescription. This lack of regulation results in antibiotics that are easily accessible, plentiful, and cheap, which promotes overuse.
The ability to purchase such medication online has also added fuel to the fire even in countries where antibiotics are regulated.

NON COMPLIANCE BY PATIENTS.
Non compliance means that patient is not following advice of doctor properly.Let me simply it for u. Suppose a doctor advices a patient to take prescribed antibiotic for 5 days in order to treat infection completely.Most of the patients take medication for 2 to 3 days till then they achieve symptomatic relief and leaves rest of medication unconsumed.Patient thinks that symptomatic relief means " I am disease free now" which is not the caae.
Non compliance thus leads to * SUBOPTIMAL AND SUBTHERAPEUTIC* drug dose delivery to the bacteria. As a result most of the bacteria are only inactivated not killed. This gives bacteria chance to adapt and develop resistance gradually.

INAPPROPRIATE PRESCRIPTION OF ANTIBIOTIZCS
It includes prescription of wrong medication , suboptimal dose or for suboptimal period or combination of these. All these factors add fuel to the fire

veterinary and pharmaceutical industries also contribute.

CONSEQUENCES
Resistance is developong , so what?
We are heading towards post antibiotic era in which it will become difficult for us to treat common and now called mild and easily curable infections.
We will have to try more deadly , less effacious and more costly medications in mild infections.What about antibiotics given after major surgeries, organ transplantation etc. As a result out progress i field of medical science will pummet to ground .Our hardship of centuries will be all in vain.

So if measures are not taken in time we are going to land in post antibiotic era with mortility and morbidity due diseases worse than. pre antibiotic era.So what measures should we take?

PREVENTION AND CONTROL

We all are responsible for this scenario, therfore all of us will have to work in collaboration for fruitful reaults to arrive.Let me summarise our role briefly

ROLE OF INDIVIDUAL
Let us
Only use anttibiotics rationally ,that is, use of " RIGHT MEDICINE FOR RIGHT PATIENT IN RIGHT PROPORTION AND FOR RIGHT PERIOD OF TIME.

POLICY MAKERS
WEe as policy makers must take some necessary steps as

Ensure a strict national action plan .

Ensure effecive antibiotic reaistant disease surveillance programs.

Strengthen policies, programmes, and implementation of infection prevention and control measures.

Regulate and promote the appropriate use and disposal of medicines.

Educate public regarding hazards of antibiotic resistance.

HEALTH PROFESSIONALS

They must follow the RIGHT formulla mentioned above.

Similarly people working in fields of agricultral and pharmaceutical companies will have to dig deep their conscience for society to survive .

Let me only mention names of some initiatives taken by WHO in this regard
The Global Antimicrobial Resistance Surveillance System (GLASS)
World antibiotic awareness week.(13 to 19 november)
Global Antibiotic Research and Development Partnership (GARDP)
Interagency Coordination Group on Antimicrobial Resistance (IACG)
All these measures will onnly suffice when each one of us acts as a responsible citizen.
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