Antimicrobial Resistance and stewardship strategies to optimize the activity of currently available agents
Itee SharmaDr. D.S. Arora
Contents Page No.
➢ Introduction 3
➢ Definitions 4
➢ History 5
➢ Major antibiotics in common use 6
➢ Graphical Representation Evolution
of resistance to ß-lactam antibiotics 7
➢ Causes of antimicrobial drug resistance 8
➢ Basic mechanism of antibiotic resistance 13
➢ Drug-resistant microbes of concern today 14
➢ Potential selection risks associated with the prescription of major antimicrobial classes 18
➢ The Impact Of Antimicrobial Resistance 19
➢ Approaches to combat antimicrobial resistance:
Antibiotic Stewardship 20
➢ Institution practice 21
➢ Conclusions 23
➢ References 24
Since their discovery during the 20th century, antimicrobial agents (antibiotics and related medicinal drugs “Wonder Drugs”) have substantially reduced the threat posed by infectious diseases, along with the combined improvements in sanitation, housing, and nutrition, and the advent of widespread immunization programs. It has led to a dramatic drop in deaths from diseases that were previously widespread, untreatable, and frequently fatal, thus contributing to the major gains in life expectancy.
These gains are now seriously by jeopardized another recent development which is the emergence and spread of microbes that are resistant to cheap and effective first-choice, or "first-line" drugs.
The bacterial infections which contribute most to human disease are also those in which emerging and microbial resistance is most evident like diarrheal diseases, respiratory tract infections, meningitis, sexually transmitted infections, and hospital-acquired infections.
Resistance to drugs commonly used to treat malaria is of particular concern.
1. What are antibiotics?
Antibiotics are defined as chemical substances produced by living organisms that is harmful to other microorganisms. Penicillin was first discovered by Dr. Alexander Fleming in 1928.
2. What are antimicrobial agents?
Antimicrobial agent is a general term for drugs, chemicals, or other substances that either kill or slow the growth of microbes. Among the antimicrobial agents are antibacterial drugs, antiviral agents, antifungal agents, and anti-parasitic drugs.
3. What is antimicrobial resistance?
Antimicrobial resistance is the ability of microbes, such as bacteria, viruses, parasites, or fungi, to grow in the presence of a chemical (drug) that would normally kill it or limit its growth.
4. What are nosocomial infections?
Nosocomial infections are those infections which are acquired by the patient as a result of treatment in hospital or any health-care unit. Thus, these are also known as hospital acquired or health-care acquired infections. Any infection which appears after 48 hours or more of hospital admission or within 30 days after discharge from the hospital can be considered as nosocomial infection.
In 1928 while working with Staphylococcus bacteria, Scottish scientist Alexander Fleming noticed that a type of mold growing by accident on a laboratory plate was protected from, and even repelled, the bacteria. The active substance, which Fleming called penicillin was literally an antibiotic - it killed living organisms.
Thus began the age of using natural and, later, synthetic drugs to treat people with bacterial infections & thus have saved countless lives and blunted serious complications of many feared diseases and...