Antibiotic resistance refers to when microorganisms, including bacteria, can survive exposure to antibiotics, making them resistant to the drugs’ effects. This issue has been prevalent since the discovery of antibiotics. While bacteria developing resistance is a natural part of evolution, certain human factors accelerate this process. One significant contribution is the over prescription of these drugs, which will be addressed in this discussion.
The constant exposure of bacteria to antibiotics has led to the rapid development of resistant forms. Despite the acknowledged issue of antibiotic resistance, doctors persist in overprescribing antibiotics. Decreasing unnecessary prescriptions is a clear solution, but additional precautions are necessary as well. Introduction: For more than 50 years, physicians have depended on antibiotics for the prompt and effective treatment of common infections.
Since their initial use, antibiotics have revolutionized the understanding and treatment of bacterial infections for medical professionals and the general population. However, the ongoing issue of antibiotic resistance has posed challenges for doctors (Stearns and Koella, 2008). The discovery of penicillin by British scientist Alexander Fleming in 1928 marked the beginning of modern antibiotics. Large-scale production of penicillin began in 1942 through collaboration between organizations in Britain and America. During World War II, extensive marketing campaigns led to widespread utilization and popularity among the public.
During the time period when penicillin was widely regarded as a miraculous medication, people were fascinated by its ability to heal previously fatal illnesses overnight. However, the initial belief in invincibility and miracles soon faded away. Alexander Fleming, the discoverer of penicillin, had cautioned early on about the need for careful dosage and the rapid mutability of bacteria in response to the drug. When he accepted his Nobel Prize in 1945, Fleming specifically expressed concerns regarding bacterial resistance resulting from misuse of the drug.
Worries were specifically focused on two issues: over prescription and under dosing. In the case of under dosing, if a patient doesn’t take enough of the drug, bacteria may not be completely killed off. This can lead to the survival and reproduction of antibiotic-resistant bacteria that carry an antibiotic-resistant gene (Stivers, 2007). Fleming’s expectations were confirmed when reports of penicillin resistance emerged within a year. By 1945, a British hospital reported that nearly 8% of staphylococcal isolates were resistant to penicillin. The situation worsened by 1949, with almost 60% of British clinical isolates showing resistance to penicillin.
According to Stearns and Koella (2008), the United States witnessed a similar occurrence of antibiotic resistance evolution and conflict with antibiotic development. This issue became a significant public health concern by the early 1970s, within a span of three decades. Bacterial strains that were previously susceptible to penicillin treatment, including those causing meningitis and ear infections in children, as well as the strain responsible for gonorrhea, regained their pathogenic capabilities.
More than six decades ago, antibiotics began to be extensively utilized. Nowadays, the emergence of bacterial resistance towards these medications is recognized as a major health concern. The absence of advancements in antibiotic development since 1968 might worsen this problem, leading to a potential scenario where once controllable diseases could turn deadly again. Presently, addressing bacterial illnesses has become increasingly difficult and expensive.
According to Stivers (2007), bacterial resistance is a significant worldwide health concern due to various reasons. The issue stems from multiple causes, but certain factors can be identified as contributing to it. These factors comprise the excessive use of antibiotics in livestock, the potential transmission of resistant bacteria during international travel, and the crucial problem of misuse emphasized by Fleming in 1945.
Currently, the problem of excessive medication prescription continues to exist and has a significant effect on bacterial resistance (Stivers, 2007). In the case of large-scale livestock farms, cows and other animals are frequently given antibiotics as a precautionary measure against outbreaks in unsanitary and overcrowded conditions that are common in this industry. The main reason for this practice is its immediate cost-effectiveness compared to the long-term expenses involved in creating clean living environments for the animals.
The primary cause of the emergence of resistant bacteria is the excessive use of antibiotics, which is further exacerbated by administering drugs to animals for their rapid growth. As a result, these animals become carriers of antibiotic-resistant bacteria, leading to significant resistance development. This poses a risk for humans as they can contract infections from consuming undercooked meat or other indirect sources contaminated with these resistant bacteria (Walters, 2003).
The text highlights the fact that antibiotics are effective against bacterial infections but not viral infections. A majority of doctors in the United States understand this distinction, yet there is still an issue with excessive prescription of antibiotics despite antibiotic resistance. Research shows that doctors’ perception of patients’ expectations regarding antibiotics influences their prescribing practices. If a physician believes a patient expects antibiotics, there is a 25% increase in the likelihood of prescribing them. Advertising also shapes patient expectations and encourages them to ask for specific medications, leading physicians to consider prescribing requested drugs (Stivers, 2007). This misuse of medication has broader social implications and should be taken seriously.
According to Avorn and Solomon, antibiotics have different impacts on patients and the ecosystem, which can have significant consequences. This conversation will explore the biological factors involved in the development of antibiotic resistance in bacteria. Bacterial resistance can occur through three primary mechanisms: mutation, transfer of genetic material, and the selection of resistant species. Mutations can result in previously susceptible bacterial species acquiring resistance.
A mutation is a natural and spontaneous genetic change that occurs randomly. It should be noted that antibiotics do not cause mutations, but their frequent usage can create pressure for the selection of bacteria that are resistant due to mutations. This phenomenon can be viewed as an extreme form of Darwinian evolution, where the idea of “survival of the fittest” applies during antibiotic treatment because bacterial replication has a short generation time.
According to Galley (2001), the rapid emergence of mutational resistance can greatly and quickly diminish the effectiveness of an antibiotic. Bacteria can become resistant to antibiotics by acquiring genetic material, either through the uptake of plasmids – non-chromosomal DNA loops – or through chromosomal inserts. Chromosomal inserts consist of transposons, which are DNA sections capable of moving between different DNA molecules, as well as genes transferred by bacteriophages, viruses that infect bacteria.
Penicillin resistance in certain bacteria develops through the ability of some species to absorb and incorporate fragments of DNA from dead cells of related species, resulting in “mosaic” genes (Galley, 2001). This process is one mechanism by which bacterial resistance can occur. Another way is through the selection of resistant bacterial species, which is based on Charles Darwin’s theory of natural selection and the concept of “survival of the fittest”. Bacteria that are regularly exposed to antibiotics gradually adapt to their presence.
Each person is unique, just like every bacterium. Similar to how certain individuals seem more resistant to specific illnesses, some bacteria are better equipped to survive in particular environments. When an environment is filled with antibiotics that kill bacteria, most of the bacteria will perish. However, the fittest bacteria will survive. These surviving bacteria become the foundation for the next generation and will pass on their traits to their offspring. Consequently, more bacteria in the subsequent generation will be able to withstand exposure to the same antibiotic.
According to Walters (2003), natural selection and constant exposure to drugs have resulted in increased resistance in each generation. To address this significant issue, possible solutions are being explored. One potential solution is the implementation of antibiotic rotation or cycling, wherein drugs are regularly switched, aiming to slow down the evolution of resistance and the spread of bacteria.
The idea behind this approach is that continuously exposing bacteria to different environmental conditions may hinder their ability to adapt and evolve as desired. However, research has shown that drug cycling has not produced significant outcomes (Stearns and Koella, 2008). According to Helen Galley, abruptly eliminating selection pressure might result in a return of sensitivity, but this process is likely to be slower than the initial development of resistance (2001). There is considerable evidence suggesting a connection between antibiotic usage and the increase in resistance.
The most efficient strategy to address antibiotic resistance is to regulate the use of antibiotics, taking into account the recent rise in resistance and unnecessary usage. However, additional research is necessary to determine the optimal approach. It is probable that restricting antibiotic prescription and advancements in microbiology will yield better results in decreasing antibiotic resistance compared to conscious antibiotic cycling (Stearns and Koella, 2008). In conclusion,
Antibiotic resistance poses an immediate and growing concern, which may become increasingly perilous over time. Addressing this issue necessitates involvement from scientists and the general public alike. It is imperative for both parties to actively engage in combatting bacterial resistance and implementing effective strategies. We possess knowledge about how bacteria acquire resistance and are well-aware of the human factors that contribute to this phenomenon. Consequently, it is vital to take all essential actions in order to prevent this potentially dangerous problem from reaching unfavorable levels.
