There is widespread over prescription and misuse of antibiotics in North America and other parts of the world. The excessive use of antibiotics in agriculture, animal husbandry, veterinary and human medicine are said to be promoting new strains of pathogenic bacteria that sequentially resist conventional antibiotics. This in turn is compelling pharmaceutical researchers and manufacturers to produce newer and newer antibiotics that attack the pathogens in novel ways the pathogens have not yet learned to overcome. This also creates the need to have generations of antibiotics and those that are effective against bacteria that are resistant to specific antibiotics. The problem of bacterial resistance thus is a continuing enigma for medical and market researchers, which stimulates a relentless war of 'wonder-drugs' against 'super-bugs'.
A Skeptic's View Of Antibiotics
2000 B.C. – Here, eat this root
1000 A.D. – That root is heathen. Here, say this prayer.
1850 A.D. – That prayer is superstition. Here, drink this potion.
1920 A.D. – That potion is snake oil. Here, swallow this pill.
1945 A.D. – That pill is ineffective. Here, take this penicillin.
1955 A.D. – Oops....bugs mutated. Here, take this tetracycline.
1960-1999 – 39 more "oops"...Here, take this more powerful antibiotic.
2000 A.D. – The bugs have won! Here, eat this root.
- Anonymous Skeptic
The Root Cause of Bacterial Resistance
Most health experts, including those at the Centers for Disease Control and Prevention (CDC) agree that the over prescription and misuse of antibiotic drugs are the main causes of bacterial resistance. According to the CDC up to half of the estimated 100 million prescriptions for antibiotics written annually are not justified. Unfinished antibiotic courses may encourage resistance because they may kill only those bacteria that are most susceptible to antibiotics, leaving the hardier bacteria or their strains to reproduce and cause more deeper and severe infections. Additionally, if the bacteria come into contact with but are not killed by the antibiotic, they are likely to adapt their cell structure and contents (including enzymes) to make themselves resistant to that antibiotic in the future. Some patients have a tendency to not to use the given antibiotic correctly as prescribed.
Viruses usually cause common illnesses like colds and flu. Some doctors prescribe antibiotics in such conditions and some more (mis)-informed consumers rush to administer antibiotics to themselves and their relatives. These antibiotics don't kill viruses, only bacteria, and are therefore useless in fighting viral infections, on the other hand kill harmless bacteria and encourage pathogenic bacteria to colonize and become stronger (resistant to common antibiotics). Bacteria reproduce by dividing into new strains of themselves. Usually the new bacterial strains have different characteristics than the original that make it resistant to an antibiotic. Bacteria have the ability to "share" resistant characteristics with each other outside of reproduction or multiplication. This makes it possible to transfer resistance from one person to another through exposure to resistant bacterial strains.
Experts have linked the phenomenon of bacterial resistance in humans to the use of preventive antibiotics in animal feed. In 1995, an estimated 4.5 million pounds of antibiotics were used to reduce the spread of disease and enhance the growth of cattle, swine and poultry. This seems to be a major contributing factor to the problem of bacterial resistance and is under review by several agencies including the U.S. Food and Drug Administration (FDA). Antibacterial hand and body washes were also under scrutiny. The FDA convened a panel of experts to examine the possible role of antibacterial hand and body wash products in promoting bacterial resistance. The panel determined that antibacterial wash products were not a public health concern.
A Driver or a Restraint
Whatever the origin and evolution of antibiotic resistance, the problem of bacterial resistance brings out two strong contradicting issues. On one hand, strict guidelines for the use of antibiotics are being evolved and implemented aimed at reducing indiscriminate use of antibiotics. This may be in terms of correct dosing in specific and selected and properly diagnosed infections, for the correct period or duration of time, in carefully selected patients. Apparently, the measures are restrictive of antibiotic usage and from a market analyst viewpoint a major restraint for antibiotics.
On the other hand, pharmaceutical researchers and manufacturers are compelled to keep their pipelines of antibiotics. Many bacteria have developed resistance to conventional antibiotics. Manufacturing new antibiotics that overcome this resistance is one of the most serious challenges facing medical science. As novel antibiotic classes, new generation groups of existing categories are introduced the very issue of bacterial resistance appears to be a driver. It is like playing a game of chess with the bacteria. As the bacteria try to checkmate the best antibiotic move, the new antibiotic molecule attempts at checkmating the new bacterial strain. Encouraged by past successes manufacturers continue to introduce new antibiotics and keenly keep their pipelines active. Pharmaceutical researchers and manufacturers will continue to face this enigmatic issue of bacterial resistance that sometimes appears to be a restraint and sometimes seems to have mutated into a market driver for many years to come. There does not seem to be a conclusion in sight.
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Last updated on: 27/08/2010
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