While the use of antibiotics has saved millions of lives, their pervasive use in treating infections has increased antimicrobial resistance. The use, overuse, and abuse of antibiotics have been associated with creating antibiotic-resistant strains of bacteria. Overuse of antibacterial is common if the infection-causing microorganisms are not identified (Kardos, 2017). Overuse and misuse of antibiotics are common in various practice settings, including primary care settings and long-term care settings. There are certain classes of bacteria that are resistant to multiple antibiotics. According to Kardos (2017), the overuse and misuse of broad-spectrum antibiotics are significant factors in antibiotic resistance. For instance, second and third-generation cephalosporins are associated with the development of methicillin resistance.
Antibiotic overuse drives resistance, with studies showing a relationship between antibiotic use and the dissemination of resistant strains. Bacteria possess plasmids, which are mobile bacterial genetic material, from which nonrelative bacteria can acquire genes. Additionally, genes can be inherited from relatives. According to Ventola (2015), this phenomenon is known as horizontal gene transfer (HGT), which allows the transfer of antimicrobial resistance between different bacterial species. Bacteria also mutate, and resistance can occur from mutation. When antibiotics clear drug sensitive-competitors, resistant bacteria are left to reproduce, leading to natural selection and the reproduction of nonsensitive bacteria.
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Inappropriate prescribing of antibiotics through the provision of subtherapeutic and subinhibitory concentrations is a common problem that can lead to antibiotic resistance. This practice has been associated with genetic alterations, including mutagenesis, HGT, and changes in gene expression. Change in gene expression leads to an increase in virulence, while increased HGT and mutagenesis lead to antibacterial resistance and the spread of bacteria (Ventola, 2015). The use of antibiotics in subinhibitory concentrations enriches bacterial genes, thereby reducing overall bacterial mortality. The suboptimal use of antibiotics in hospitals is also a common problem where antibiotics are prescribed even when a patient’s condition is caused by a virus.
References
Kardos, N. (2017). Overuse of Antibiotics and Antibiotic Resistance in Medical Applications Featuring Carbapenemase Resistant Enterobacteriaceae (CRE). SOJ Microbiology & Infectious Diseases , 5 (5), 1–21. https://doi.org/10.15226/sojmid/5/5/00183
Ventola, C. L. (2015). The antibiotic resistance crisis: part 1: causes and threats. P & T : A Peer-Reviewed Journal for Formulary Management , 40 (4), 277–283. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378521/
