Analysis

Antibiotics’ usefulness, which has reformed healthcare and protected countless lives, is in risk owing to the growing upsurge of unaffected microbes everywhere across the world. Microbial diseases have re-emerged many generations after the preliminary victims were preserved with antibiotics. The exploitation as well as misapplication of antibiotics, as well as a shortage of novel drug study by the therapeutic segment due to inadequate financial rewards and problematic controlling necessities, have all been responsible for the crisis of antibiotic resistance (Aslam, et al., 2018).

The treatment of microbiological illnesses in Egyptian Civilization, Athens, as well as China has indeed been discovered to be well documented. The countries- Egypt and China have successfully developed the treatment of microbiological illness. Sir Alexander Fleming discovered penicillin in 1928, ushering in the current generation of antibiotics. Antibiotics have changed contemporary healthcare as well as saved countless lives after then. In the year the 1940s, medicines were initially administered to cure serious illnesses. Penicillin resistance developed quickly after that, and by the 1950s, several of the previous decade’s achievements were in jeopardy (Larsson & Flach, 2021). Beta version antibiotics were subsequently discovered, manufactured, as well as administered in response, restoring trust (Hernando-Amado, et al., 2019). The aim of the paper is to discuss the global nature of ‘antibiotic resistance’ and conduct an analysis on the working of antibiotic resistance. The objective of the paper is to understand the misuse of antibiotics and how this have turnerd into a global issue.  

 

Figure 1: Anti-biotic Resistance

(Source: Alam., Z, 2019)

After researching antibiotic resistance, it was analyzed that Antibiotics are medications that delay or stop germs like bacteria, fungus, and parasites from growing. When microbes acclimatize to the medication that is supposed to kill them, they become resistant to it as well as persist to reproduce in its proximity. Following the development of the very first antibacterial, penicillin, in the year 1928, additional antibiotic breakthroughs accelerated, especially between the 1940s and 1980s. Viruses have proven the potential at becoming resistant to each antibiotic used in the past seven decades, according to research. Antibiotic resistance develops more quickly when more medicines are used. Furthermore, the usage of antibiotics anywhere at time and in any context places biological stress on bacteria, promoting resistance development (Aslam, et al., 2018). Antibiotics must be used whenever possible to treat or prevent illness. On the contrary, studies reveal that antibiotics are administered up to 50percent of the frequency when medicines are not required or are overused (for example, a patient is given the wrong dose). Antimicrobial resistance is promoted unintentionally as a result of this incorrect usage of antibiotics. We could analyze that improper antibiotic usage is a cause of resistance, suggesting that 1 of the numerous reasons for the high rate of antibiotic usage is a lack of awareness of the distinctions among bacteria, infections, as well as other diseases, as well as the right use and utility of antibiotics (Dong, et al., 2021). The above mentione issues proves that ‘antibiotic misuse’ is indeed a global issue.

Data Analysis

According to a 2004 survey by the Infectious Diseases Society of America (IDSA), authorization of antibacterial drugs by the Foods and Drugs Agency (FDA) declined by 56% during 1998 until 2002, contrasted to authorization throughout 1983 as well as 1987.

In addition to this, we could also analyze that Antibiotics are frequently administered for no good reason. For viral diseases like respiratory infections, influenza, as well as diarrhea, too many antibiotics are recommended. Consequently, journalists and others frequently promote these public beliefs. For instance, general terminology like ‘germs’ and ‘bugs’ can be used. Antibiotics, which are used for contemporary medicinal purposes, have also resulted in antibiotic resistance (Nwafia, et al., 2022). Resistance to antibiotics has now reached a critical stage, posing a major threat to worldwide public wellbeing. Furthermore, the rising incidence of antibiotic-resistant diseases represents such a serious threat to civilization that, within twenty years, we may be transported back to a late nineteenth world where regular surgeries killed us as a consequence of common infections (Nwafia, et al., 2022).

As per the World Health Organization report from 1993 to 1996, approximately half of UTI patients were improperly administered medications in 13 low, middle, and high-income countries. Antibiotic resistance is a worldwide issue that occurs when an illness fails to react to routine treatment, reducing the effectiveness of therapeutic antibiotics and hence prolonging sickness and increasing the chance of death. In this circumstance, it is always preferable to avoid avoidable difficulties in patients as a result of unneeded and irrational antibiotic treatment.

Table 1: impact of rationally prescribed medications or antiniotics onto various diseases

Disease	Control Group	Test Group
	Recommended Antibiotic Prescribed	Surgical Site Infection observed (Number of patients)	Additional antibiotic in treatment regime	Surgical site infection Observed (Number  of patients)
Acute Gall stone	Ceftriaxone / Ciprofloxacillin	3	Amikacin & Metrogyl	Nil
Cholecystitis	Ceftriaxone / Ciprofloxacillin	11	Amikacin & Metrogyl	2
Acute Abdomen	Ceftriaxone / Ciprofloxacillin	4	Amikacin & Metrogyl	Nil
Pancreatitis	Meropenum	3	Metrogyl	1
Appendicitis	Ceftriaxone/ Cefotaxime	4	Amikacin & Metrogyl	1
Colonic Growth	Ceftriaxone / Cefotaxime	4	Amikacin & Metrogyl	Nil

(Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193353)

The above figure shows that in compared to the control unit, which was treated just with prescribed antibiotics, the administration of extra antibiotics within test group together with prescribed antibiotics considerably reduced the SSI within test group.

Table 2: impact of non-rationally prescribed medications or antiniotics onto various diseases

Disease	Control Group (14)	Test Group (15)
	Recommended Antibiotic Prescribed	SSI observed (Number of patients)	Additional antibiotic in treatment regime	SSI Observed (Number of patients)	Additional complications (Number of patients)
Diabetic Foot	Augmentin	1	Clarithromycin	1	Gastrointestinal upset [3]
Breast Abscess	Amoxycillin	1	Clarithromycin	4	Drug resistant [4]
Hernia & Hydrocoele	Ceftriaxone/ Cefotaxime	2	Amoxycilline & Clavulonic acid	2	Gastrointestinal upset [6]

(Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492205/)

The above figure indicates that using supplemental antibiotics within test group in combination to the prescribed antibiotics unable to decrease SSI within test group when compared to the control group that was only given the prescribed antibiotics. The administration of extra medicines in the test group, on either hand, exacerbates other issues such as GI discomfort and so on.

Research also made us aware of the fact that resistance to antibiotics is hardly a recent concern. As earlier indicated, Fleming foresaw the issue about sixty years ago. Such signals, as per Dr. Solomon, have indeed been neglected in the past, specifically while antibiotic discovery was at its maximum. Despite several warnings concerning resistance, practitioners got careless about maintaining antibiotic efficiency because new medications constantly appeared to be accessible. However, in the last 30 years, the bottleneck for discovering newer antibiotics has shrunk as well as is now dry.”  (Wang, et al., 2019). Physicians are increasingly encountering individuals with illnesses that are essentially resistant to treatment since germs have developed to withstand our current medications. However, healthcare practitioners have begun to be more cautious when administering antibiotics which could reduce the misue of antibiotics (Choi, et al., 2021).

Statistical Data

Reflecting over the last thirty years, the field of healthcare has seen incredible advancement. Considering this, there has occurred a considerable drop in novel antimicrobial research and innovation. According to a 2004 survey by the Infectious Diseases Society of America (IDSA), authorization of antibacterial drugs by the Foods and Drugs Agency (FDA) declined by 56% during 1998 until 2002, contrasted to authorization throughout 1983 as well as 1987. In addition, neither of the 89 novel medications authorized by the FDA in 2002 were antibacterial (King, Fleming-Dutra & Hicks, 2018). As a result, we have been using similar antibiotics for generations, allowing bacteria more opportunities to adapt and acquire resistance. Furthermore, bacterial cases have emerged which are potentially resistant to presently offered medicines, including methicillin-resistant Staphylococcus aureus. The issue is that producing newer antibiotics has grown a more difficult, expensive, and time-consuming procedure. Dr. Brad Spell burg, assistant professor of psychiatry at the University of California-Los Angeles (UCLA) as well as a writer of the Internal audit report, asserts in a newspaper accepted for publication by the Alliance for the Prudent Use of Antibiotics (APUA) that the “close to the bottom fruit” has been snatched when it arrives at recognizing new antimicrobial agents. Furthermore, medication testing for new antibiotics usually yields identical chemical constituents,” he explained. Following the sulphonamides, greater than 100 antimicrobial properties have indeed been produced for clinical usage in the United States (Tamhankar & Stålsby Lundborg, 2019).

Each successive generation has increased the standard for what is required to find and produce the next iteration. Economic concerns have hampered the discovery of newer antibiotics. “The greatest apparent would be that antibiotics are generally short-course medicines, and firms know they will make much more money selling a drug you will have to use each day for the remainder of the time (Melander & Melander, 2017). Furthermore, there exist many different sorts of illnesses, and clearance for one kind only provides a business a piece of the whole market pie. Antihypertensive medicines are not prescribed to cure hypertension of the lungs or hypertension affecting the kidneys when they are authorized. They have been authorized for the treatment of hypertension. Different antibiotics are prescribed to treat “invasion aspergillosis” or “intrusive candida” when they are authorized (Yelin & Kishony, 2018).

Moreover, we observe that China consumes the most significant degree of antibiotic resistance, trailed by U.S. and Kuwait. In an investigation of obstruction examples of a few most normal microbes in China in the year 1999 till 2001, the uncaring commonness of opposition among emergency clinic gained diseases was just about as high as 41% (with a reach from 23% to 77%) and that among local area procured contaminations was 26 percent (with a reach from 15 percent to 39 percent). China additionally has the furthermost reckless development pace of opposition (22% normal development in a review crossing the year 1994 till 2000). Moreover, Kuwait comes at second position (17% normal development during the time from the year 1999 till 2003), and finally the U.S. is the least (6 percent from the year 1999 till 2002). Examples of obstruction around the 3 nations are not exceptionally corresponded; the greatest associated were Kuwait and China, trailed by U.S. and Kuwait as well as the most un-related pair was the U.S. and the China  (Schwartzkopf, 2019).

National Guidelines

Table 3: Use of Antibiotic Resistance

 

(Source: Schwartzkopf, 2019)

According to the authors, world leaders believe that creating novel antibiotics is one strategy to address resistance to antibiotics. United States Ministry of Health Services (HHS) revealed last year that it had created a partnership with the pharmaceutical giant GlaxoSmithKline to research new medications to tackle resistance to antibiotics and biological warfare. Continuing to work as commercial alliances and taking a holistic approach to building a strong funnel of new antibiotics which area deals in the country’s readiness as well as the emerging danger of resistance to antibiotics has been discovered to be a new method to move forward towards building a strong funnel of novel antibiotics (Sommer, et al., 2017).

However, creating new antibiotics would not be enough to combat resistance. The manner antibiotics are administered to treat and utilized by consumers has to change dramatically, as it has been a major cause of resistance. Antibiotics should only be used when recommended by a doctor, according to the World Health Organization. Individuals should also complete their antibiotic prescriptions, even if they are experiencing healthier, and neither share nor consume leftover medications (Larsson & Flach, 2021). Whenever it relates to health care providers, WHO recommends that they only give antibiotics while patients are actually in need of them and that they make sure they are administering the right antibiotic for the job. Antimicrobial resistance can be combated in part by avoiding illness in the first place. Antibiotics are used less frequently when infections are avoided, which minimizes the risk of resistance developing. Vaccination, infection control efforts in healthcare environments, clean food production and storage, and basic washing hands can all help to avoid drug-resistant illnesses  (World health organisation, 2018).  

 

Figure 2: Evaluation of Antibiotics

(Source: Cars, 2021)

Conclusion

From the above case, it can be concluded that the globe is facing a significant antibiotic resistance crisis as a result of the misuse of antibiotics. Resistance to antibiotics is a word that refers to a virus’s capacity to adjust to antibiotics over time and so become impenetrable. Superbugs, or germs with superpowers, multiply and exchange their DNA and defense strategies with other microorganisms. Antibiotic-resistant illnesses are currently common in the United States and around the world. Resistance to antibiotics has produced a condition similar to that of the pre-antibiotic era when nearly all infectious infections were deadly. However, the practitioners are now being extra careful when administering antibiotics. Antibiotic-resistant illnesses are becoming more widespread, and they constitute a significant medical issue. To fight the worldwide problem of resistance to antibiotics, innovative antibiotics that can aid in the coming future must be introduced. However, only new drugs would be ineffective, so people must take precautions today. Patients must never share drugs with people or utilize medications that have been left behind. Infection control measures such as proper preparation and serving, general washing hands, and others can also help to avoid drug-resistant illnesses.

References

Alam, Z. (2019, January 15). How to train the body’s own cells to combat antibiotic resistance. Retrieved from https://theconversation.com/how-to-train-the-bodys-own-cells-to-combat-antibiotic-resistance-106052

Aslam, B., Wang, W., Arshad, M. I., Khurshid, M., Muzammil, S., Rasool, M. H., & Baloch, Z. (2018). Antibiotic resistance: a rundown of a global crisis. Infection and drug resistance, 11, 1645. https://dx.doi.org/10.2147%2FIDR.S173867

Cars, O., Chandy, S. J., Mpundu, M., Peralta, A. Q., Zorzet, A., & So, A. D. (2021). Resetting the agenda for antibiotic resistance through a health systems perspective. The Lancet Global Health, 9(7), e1022-e102.https://doi.org/10.1016/S2214-109X (21)00163-7

Choi, Y. K., Byeon, E. J., Park, J. J., Lee, J., & Seo, Y. B. (2021). Antibiotic resistance patterns of enterobacteria isolated from patients with healthcare-associated infections. Infection & Chemotherapy, 53(2), 355. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258300/

Dong, H., Chen, Y., Wang, J., Zhang, Y., Zhang, P., Li, X., & Zhou, A. (2021). Interactions of microplastics and antibiotic resistance genes and their effects on the aquaculture environments. Journal of Hazardous Materials, 403, 123961. https://doi.org/10.1016/j.jhazmat.2020.123961

Gupta, V., Yu, K.C., Kabler, H., Watts, J.A. and Amiche, A., 2022. Antibiotic Resistance Patterns and Association with the Influenza Season in the United States: A Multicentre Evaluation Reveals Surprising Associations Between Influenza Season and Resistance in Gram-negative Pathogens. Open Forum Infectious Diseases.

Hernando-Amado, S., Coque, T. M., Baquero, F., & Martínez, J. L. (2019). Defining and combating antibiotic resistance from One Health and Global Health perspectives. Nature microbiology, 4(9), 1432-1442. https://doi.org/10.1038/s41564-019-0503-9

King, L. M., Fleming-Dutra, K. E., & Hicks, L. A. (2018). Advances in optimizing the prescription of antibiotics in outpatient settings. Bmj, 363. https://doi.org/10.1136/bmj.k3047

Larsson, D. G., & Flach, C. F. (2021). Antibiotic resistance in the environment. Nature Reviews Microbiology, 1-13. https://doi.org/10.1038/s41579-021-00649-x

Larsson, D. G., & Flach, C. F. (2021). Antibiotic resistance in the environment. Nature Reviews Microbiology, 1-13. https://doi.org/10.1038/s41579-021-00649-x

Melander, R. J., & Melander, C. (2017). The challenge of overcoming antibiotic resistance: an adjuvant approach?. ACS infectious diseases, 3(8), 559-563. https://doi.org/10.1021/acsinfecdis.7b00071

Nwafia, I., Ohanu, M., Ebede, S., Okoil, C., Nwachukwu, P., Umenzekwe, C., & Izundu, D. (2022). Antibiotic use and resistance: Assessment of healthcare workers’ knowledge, attitude, and practice. International Journal of Medicine and Health Development, 27(1), 31-31. https://link.gale.com/apps/doc/A686069122/HRCA?u=anon~4a3814ef&sid=googleScholar&xid=638c2622

Schwartzkopf, E. (2019). Antibiotic Resistance Becomes International Threat. Microreviews in Cell and Molecular Biology, 5(1). https://globalizationandhealth.biomedcentral.com/articles/10.1186/1744-8603-2-6

Sommer, M. O., Munck, C., Toft-Kehler, R. V., & Andersson, D. I. (2017). Prediction of antibiotic resistance: time for a new preclinical paradigm?. Nature Reviews Microbiology, 15(11), 689-696. https://doi.org/10.1038/nrmicro.2017.75

Tamhankar, A. J., & Stålsby Lundborg, C. (2019). Antimicrobials and antimicrobial resistance in the environment and its remediation: A global one health perspective. International Journal of Environmental Research and Public Health, 16(23), 4614. https://doi.org/10.3390/ijerph16234614

Wang, C. Y., Chen, Y. H., Fang, C., Zhou, M. M., Xu, H. M., Jing, C. M., & Zhang, C. H. (2019). Antibiotic resistance profiles and multidrug resistance patterns of Streptococcus pneumoniae in pediatrics: a multicenter retrospective study in mainland China. Medicine, 98(24).

WHO. (2018). High levels of antibiotic resistance found worldwide, new data shows. Retrieved from https://www.who.int/news/item/29-01-2018-high-levels-of-antibiotic-resistance-found-worldwide-new-data-shows

Yelin, I. and Kishony, R. (2018). Antibiotic resistance. Cell, 172(5), 1136-1136.