ANTIBIOTICRESISTANT MICROORGANISMS THE INCREASING PREVALENCE OF BACTERIA RESISTANT
ANTIBIOTIC-RESISTANT MICROORGANISMS THE INCREASING PREVALENCE OF BACTERIA RESISTANT TO THE EFFECTS OF ANTIBIOTICS, IN BOTH COMMUNITY-ACQUIRED AND NOSOCOMIAL INFECTIONS, IS A MAJOR PUBLIC HEALTH CONCERN. ANTIBIOTIC RESISTANCE OCCURS IN MOST HUMAN PATHOGENS.
INFECTIONS CAUSED BY DRUG-RESISTANT ORGANISMS OFTEN LEAD TO PROLONGED ILLNESS OR HOSPITALIZATION, AND INCREASE MORTALITY RATES. RESISTANT MICROORGANISMS GROW AND MULTIPLY WHEN SUSCEPTIBLE ORGANISMS (E. G. NORMAL FLORA) ARE SUPPRESSED BY ANTIMICROBIAL DRUGS OR WHEN NORMAL BODY DEFENSES ARE IMPAIRED BY IMMUNOSUPPRESSIVE DISORDERS OR DRUGS. THEY MAY EMERGE DURING OR AFTER ANTIMICROBIAL DRUG THERAPY.
CONTRIBUTING FACTORS ARE: 1) WIDESPREAD USE OF ANTIMICROBIAL DRUGS, ESPECIALLY BROAD- SPECTRUM AGENTS. 2) INTERRUPTED OR INADEQUATE ANTIMICROBIAL TREATMENT OF INFECTIONS 3) TYPE OF BACTERIA 4) TYPE OF INFECTION 5) CONDITIONS OF THE HOST 6) LOCATION OR SETTING.
MECHANISMS OF RESISTANCE BACTERIA HAVE DEVELOPED NUMEROUS WAYS TO ACQUIRE RESISTANCE TO ANTIMICROBIAL DRUGS, INCLUDING: 1) PRODUCTION OF ENZYMES THAT INACTIVATE THE DRUGS.
E. G. BETA-LACTAMASE CHEMICAL STRUCTURE ENZYMES OF CHANGE PENICILLINS THE AND CEPHALOSPORINS BY OPENING THE BETA-LACTAM RING AND PREVENTING THE ANTIBIOTIC FROM BINDING WITH ITS TARGET SITE (CALLED PENICILLIN-BINDING PROTEINS) IN THE BACTERIAL CELL WALL
2) GENETIC MUTATIONS THAT CHANGE ANTIBIOTIC TARGET SITES OR CHANGE THE GENETIC CODE TO PRODUCE NEW TARGETS. THESE CHANGES SUSCEPTIBILITY DECREASE BACTERIAL TO AN ANTIBIOTIC, LARGELY BY ALTERING BINDING SITES. 3) CHANGING THEIR METABOLIC BYPASS ANTIBIOTIC ACTIVITY. PATHWAYS TO
4) CHANGING THEIR CELL WALLS TO PRODUCE PORINS THAT PREVENT PENETRATION OF THE DRUG.
5) ACQUIRING THE ABILITY TO PUMP DRUG MOLECULES OUT OF THE CELL. 6) TRANSFERRING GENETIC MATERIAL ( DNA ) BETWEEN MICROORGANISMS. BACTERIA HAVE EFFICIENT MECHANISMS FOR GENETI EXCHANGE THAT ALLOW THEM TO SPREAD ANTIBIOTIC RESISTANC FROM ONE BACTERIAL STRAIN TO ANOTHER , INCLUDING DIFFEREN SPECIES OR TYPES OF BACTERIA. THUS, WHEN A NEW ANTIBIOTIC IS USED , RESISTANCE MAY RAPIDLY APPEAR AND BE DISSEMINATED TO MULTIPLE BACTERI PRINCIPLES OF THERAPY THE GOAL OF TREATMENT IS TO ERADICATE THE CAUSATIVE MICROORGANISMS AND RETURN THE HOST TO FULL PHYSIOLOGIC FUNCTIONIN ANTIMICROBIALS ARE AMONG THE MOST FREQUENTLY USED DRUGS WORLDWIDE. THEIR SUCCESS IN SAVING LIVES AND DECREASING SEVERITY AND DURATION OF INFECTIOUS DISEASES HAS ENCOURAGED THEIR EXTENSIVE USE.
. AUTHORITIES BELIEVE THAT MUCH ANTIBIOTIC USE INVOLVES OVERUSE MISUSE, OR ABUSE OF THE DRUGS. THAT IS , AN ANTIBIOTIC IS NOT INDICATED AT ALL OR THE WRONG DRUG, DOSE , ROUTE, OR DURATION IS PRESCRIBED. INAPPROPRIATE USE OF ANTIBIOTICS INCREASES ADVERSE DRUG EFFECTS, INFECTIONS WITH DRUG –RESISTANT MICROORGANISMS. IN ADDITION , IT DECREASES THE NUMBER OF EFFECTIVE DRUGS FOR SERIOUS OR ANTIBIOTIC-RESISTANT INFECTIONS.
GUIDELINES TO PROMOTE MORE APPROPRIATE USE OF ANTIBIOTICS: 1) AVOID THE USE OF BROAD-SPECTRUM A NTIBACTERIAL DRUGS TO TREAT TRIVIAL OR VIRAL INFECTIONS ; USE NARROW-SPECTRUM AGENTS WHEN LIKELY TO BE EFFECTIVE. 2) GIVE ANTIBACTERIAL DRUGS ONLY WHEN A SIGNIFICANT BACTERIAL INFECTION IS DIAGNOSED OR STRONGLY SUSPECTED OR WHEN THERE IS AN ESTABLISHED INDICATION FOR PROPHYLAXIS. 3) MINIMIZE ANTIMICROBIAL DRUG THERAPY FOR FEVER UNLESS OTHER CLINICAL MANIFESTATIONS OR LABORATORY DATA INDICATE INFECTION 4) USE THE DRUGS ALONG WITH OTHER INTERVENTIONS TO DECREASE MICROBIAL PROLIFERATION SUCH AS UNIVERSAL PRECAUTIONS e. g. HANDWASHING AND ISOLATION TECHNIQUES. 5) CONSULT INFECTIOUS DISEASE PHYSICIANS AND INFECTION CONTRO 6) NURSES AND PHARMACISTS ABOUT PATTERNS OF DRUG-RESISTANT 7) ORGANISMS AND TREATMENT OF COMPLICATED INFECTIONS.
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