Antimicrobial resistance is a natural biological phenomenon of response of microbes to the selective pressure of an antimicrobial drug. Resistance may be inherent, which explains the phenomenon of opportunistic infection or acquired. Concern about the resistance increased in the late 1990's and since then, many governmental and agency reports have been published regarding the agricultural use of antibacterials, advising less use of antibacterials, appropriate choice of antibacterials and regimens, prevention of cross-infection and development of new antibacterials. The emergence of multidrug resistant strains of Gram-negative bacteria (Pseudomonas, Klebsiella, Enterobacter, Acinetobacter, Salmonella species) and Gram-positve organisms (Staphylococcus, Enterococcus, Streptococcus species) is the more worrisome in the present therapeutic scenario. Multidrug - resistant tuberculosis is another serious public health problems. Resistance to some agents can be overcome by modifying the dosage regimens (e.g., using high-dose therapy) or inhibiting the resistance mechanism (e.g., beta-lactamase inhibitors), whereas other mechanisms of resistance can only be overcome by using an agent from a different class. It is urgently required to ban the sale of antibiotics without prescription, to use antibiotics more judiciously in hospitals by intensive teaching of the principles of the use of antibiotics and to establish better control measures for nosocomial infections. Thus, it is highly recommended that practicing physicians should become aware of the magnitude of existing problem of antibacterial resistance and help in fighting this deadly threat by rational prescribing.
Drug Resistance can be described as a state of insensitivity or of decreased sensitivity to drugs that ordinarily cause growth inhibition or cell death. This phenomenon has been recognized since the latter part of the 19th century in the micro-organisms and more recently in mammalian cells in vitro and in cancer cells in vivo. The discovery of antimicrobial agents by Paul Ehrlich was one of the most remarkable discoveries, that changed the face of medical practice. However, the increased global flow of antimicrobials brought with it the threat of antimicrobial resistance. Concern about the resistance increased in the late 1990's since then, many governmental and agency reports have been published regarding the agricultural use of antibacterials, advising less use of antibacterials, appropriate choice of antibacterials and regimens, prevention of cross-infection and development of new antibacterials. As antimicrobials are frequently misused and overused in many developing countries, thus resistance to antimicrobials, has led to an increase in morbidity, mortality and cost of health care. To maintain the useful life of antimicrobial drugs in developing countries there is need to improve access to diagnostic laboratories, improved surveillance of the emergence of resistance, better regulation of the use of antibiotics, and better education of the public, doctors, and veterinarians in the appropriate use of the drugs.
by
Dr.Akshaya Srikanth B
Pharm.D India
