Wednesday, 6 June 2012

ANTIMICROBIAL RESISTANCE


Selected theme for 2012: ANTIMICROBIAL RESISTANCE
Farhan  Ali :DVM
Faculty of veterinary Sciences Multan : BZU
                                                intellifarhan390@hotmail.com
Antimicrobials are products that kill microorganisms or keep them from multiplying (reproducing) or growing. They are most commonly used to prevent or treat disease and infections due to microorganisms”.Antimicrobial resistance mean “The result of microbes changing in ways that reduce or eliminate the effectiveness of drugs, chemicals, or other agents to cure or prevent infections”.Spectrum of antimicrobial activity  is that the antimicrobial must cause more harm to the pathogen than to the host.  This is called selective toxicity.Antimicrobials may work against only certain microbes. They can be:  Antibacterial,   Antifungal, Antiviral, Antiprotozoal.The spectrum of activity is the range of different microbes a drug is able to work against.  Narrow-spectrum means that the drug works best against only a certain group or type; broad-spectrum drugs work against a wider range of microbes. If the drug works against bacteria, a broad-spectrum drug would probably do well against both gram-positive and gram-negative organisms. A narrow-spectrum drug would work only against one or the other, or possibly an even narrower group.An ideal antimicrobial would have more effect against pathogens and less on the normal flora of the body. Unfortunately, this is not always possible.Action of antimicrobial resistance include either   ---cidal, which means they actually kill the pathogens, or ----static, which means they slow or prevent reproduction. 1. Inhibition of cell wall synthesis—since this attacks the cell wall, these drugs have little effect on host cells, which do not contain peptidoglycan. Penicillin, bacitracin, and vancomycin act in this way.2. Inhibition of protein synthesis---since ribosomes of procaryotic cells are slightly different from those of eucaryocytes, they can be used as a target. Chloramphenicol, erythromycin, streptomycin, and the tetracyclines act in this way.3. Injury to the plasma membrane—this is a mode of action of both some antibacterials and some antifungals. Antifungals are able to work mostly against fungus cell membranes because they contain ergosterol instead of cholesterol. However, these antibiotics are potentially quite toxic to the host. Examples are the polymixins,  and antifungals such as amphotericin B, miconazole, and ketoconazole.4. Inhibition of nucleic acid synthesis---selective toxicity varies, but these interfere with DNA replication and transcription. Rifampin and the quinolones are examples.5. Inhibiting the synthesis of essential metabolites---the sulfas and trimethoprim work this way. They interfere with the pathway by which bacteria synthesize folic acid.
Causes of Antimicrobial resistance include selective pressure ,Mutation ,Gene Transfer, Societal Pressures, Inappropriate Use, Inadequate Diagnostics,Hospital Use , and Agricultural Use respectively. In Selective Pressure the presence of an antimicrobial, microbes are either killed or, if they carry resistance genes, survive. These survivors will replicate, and their progeny will quickly become the dominant type throughout the microbial population.Mutation Most microbes reproduce by dividing every few hours, allowing them to adapt quickly to new environmental conditions. During replication, mutations arise and some of these mutations may help an individual microbe survive exposure to an antimicrobial.Gene Transfer Microbes also may get genes from each other, including genes that make the microbe drug resistant. Societal Pressures there are additional societal pressures that act to accelerate the increase of antimicrobial resistance. Inappropriate Use Selection of resistant microorganisms is exacerbated by inappropriate use of antimicrobials. Sometimes healthcare providers will prescribe antimicrobials inappropriately, wishing to placate an insistent patient who has a viral infection or an as-yet undiagnosed condition. Inadequate Diagnostics More often, healthcare providers must use incomplete or imperfect information to diagnose an infection and thus prescribe an antimicrobial just-in-case or prescribe a broad-spectrum antimicrobial when a specific antibiotic might be better. These situations contribute to selective pressure and accelerate antimicrobial resistance.Hospital Use Critically ill patients are more susceptible to infections and, thus, often require the aid of antimicrobials.. The extensive use of antimicrobials and close contact among sick patients creates a fertile environment for the spread of antimicrobial-resistant germs. Agricultural Use Scientists also believe that the practice of adding antibiotics to agricultural feed promotes drug resistance. More than half of the antibiotics produced in the pakistan are used for agricultural purposes. However, there is still much debate about whether drug-resistant microbes in animals pose a significant public health burden.
Antimicrobials are generally used in animal to Control of disease, Growth promotion/feed efficiency  , prevent or treat infection. Prevention for antimicrobial resistance include appropriate medication for your illness and avoid overusing or misusing medicines. Strictly follow prescription medication directions and never share or take medicine that was prescribed for someone else. Communicate effectively with your healthcare provider, so that he or she has a clear understanding of your symptoms and can determine whether an antimicrobial drug, such as an antibiotic, is appropriate. Do not save your antibiotic for the next time you get sick; take all of the medication as prescribed by your healthcare provider. If the healthcare provider has prescribed more than the required dose, discard leftover medications once you have completed the prescribed course of treatment. Do not share your medication with another person.Healthy lifestyle habits always go far in preventing illness, including proper diet, exercise, sleeping patterns, and good hygiene, such as frequent hand washing.



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