Antibiotic Resistance Issues-GS-3

Watch what you put on your hands:

Introduction

  • In a world obsessed with cleanliness, antimicrobial agents like triclosan have been touted as the panacea for a disease-free world. But their use remains controversial: experts say indiscriminate usage of antimicrobial agents like triclosan over the years has led to bacteria developing resistance to them, leading to the need for stronger chemicals.

About Triclosan

  • Triclosan was initially used for hospital environments, but its use spread as a miracle guard against infection. “Triclosan is being used in toothpaste, handwash, talcum powder, etc. because companies thought it was a panacea for all, without understanding that with indiscriminate usage, bacteria can developed a resistance to the chemical.

Soap is good enough

  • Regular soap is gentle on our skin and helps maintain commensals.
  • Certain molecules, known as lipopolysaccharides, which are specific to gram-negative bacteria, and lipoteichoic acid, specific to gram-positive bacteria, get dislodged when the bacteria are killed by antibacterial agents. They remain on the surface of your hands and can get into your gut, causing other inflammatory complications. Scrubbing with soap and water is a hundred times better.
  • Using alcohol for disinfection was better as bacteria could not develop resistance to alcohol.
  • Antimicrobials are recommended for sanitation workers, farmers working in the fields, or in the presence of someone with an infection.

Antibiotic Resistance, Its Problem and Measures:

  • Antibiotic resistance occurs when an antibiotic has lost its ability to effectively control or kill bacterial growth; in other words, the bacteria are “resistant” and continue to multiply in the presence of therapeutic levels of an antibiotic.
  • This misuse and overuse of antibiotics leads to antibiotic resistance among bacteria and consequent treatment complications and increased healthcare costs.
  • Antimicrobial resistance has cast a shadow over the medical miracles we take for granted, undermining every clinical and public health program designed to contain infectious diseases worldwide.  Limited access to medical care and effective treatments, the common practice of self-medication, and the availability of counterfeit drugs have exacerbated drug resistance in the developing world.
  • In affluent nations, infections acquired in settings such as hospitals and nursing homes are a major source of illness and death. In addition, community-acquired infections are emerging, both as independent epidemics and as primary sources of resistance in hospitals. Antibiotics are also fed to animals specially chickens.
  • While the major factor driving the emergence of drug resistance is antibiotic use, a number of other factors influence the antibiotic resistance problem, including the spread and fate of bacteria, resistance genes and antibiotics, as well as the behavioural and medical activities of people. Each contributes to producing the problem and to the difficulty in reversing it.

Prevention

  • Antibiotics’ growing lack of effectiveness has spurred a resurgence in infection surveillance and control practices; renewed efforts in vaccination; and increased attention to deficiencies in sanitation.
  • Antibacterials should be reserved for use to protect vulnerable patients from transmission of disease agents in the hospital and when they are completing recovery at home.

Conservation through prioritization of medical use.

  • The current practice of applying the most antibiotic tonnage to growth promotion in food animals and plants is incompatible with an expectation that antibiotics will cure life-threatening infections

Conservation through prescription tailored to diagnosis

  • Better diagnostics could allow prescriptions to be tailored narrowly to a pathogen’s susceptibilities. Adoption of such technology would require physician education, suitable reimbursement, and documentation of outcomes.

Conservation through controlled access.

  • In wealthier countries, all health care facilities should institute antibiotic-stewardship programs. In poorer countries, despite the need to expand access to effective antibiotics, there’s also an urgent need to reduce inappropriate use fostered by misaligned financial incentives for providers and by over-the-counter access.

Partnership.

  • Innovative experiments in public–private partnership are under way for antibiotic-drug discovery. In 2012, the Bill and Melinda Gates Foundation expanded its Tuberculosis Drug Accelerator program to include multiple drug companies, academic institutions, a foundation, and a government laboratory.

Babies fall victim to antibiotic resistance

Introduction

  • Infected with ‘superbugs’ in birth facilities within 72 hours of being born, thousands of Indian babies are dying due to an ‘alarming degree’ of drug resistance, a major study has found. The researchers found that nearly 26 per cent of babies with sepsis died, as multi-drug resistance made the ailment untreatable.
  • Despite early detection and appropriate medical attention, neonates with sepsis and pneumonia (both common ailments in newborns) died, because none of the drugs. Three ‘superbugs’ — Klebsiella, Acinetobacter , and E. coli — were associated with over half (53 per cent) of the infections.

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