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Please finish your antibiotics!

Author: Chip Kam Weng


Each year, drug-resistant bacterial infections take countless lives globally, and we anticipate a surge in numbers by 2050. The World Health Organization (WHO) has stated that antibiotic resistance is a severe public health threat, often referred to as a "silent pandemic." In the Western Pacific Region alone, an estimated 5.2 million lives may be lost by 2030 due to infections related to antimicrobial resistance (World Health Organization, 2023).





Antibiotic resistance is a significant issue, especially when dealing with troublemakers like Staphylococcus aureus (SA). Resistance to antibiotics emerges when SA encounters antibiotic levels that don’t promptly kill them (Arnold et al., 2022). Hence, subsequent encounters won’t harm them as effectively. Essentially, “What doesn’t kill me makes me stronger” – Friedrich Nietzsche. Other factors contributing to their antibiotic-resistant properties include receiving genes from other bacteria in their surrounding microenvironment (Arnold et al., 2022). You can picture this by imagining these SAs receiving gifts (the antibiotic-resistant genes) from neighboring bacterial counterparts. A common antibiotic-resistant mechanism is efflux pumps—molecular machinery that actively pumps antibiotics out of bacterial cells, reducing their effectiveness. Think of efflux pumps as specialized gatekeepers expelling antibiotics before they can exert their intended action within the cell (Van Bambeke et al., 2000). This sophisticated pump mechanism enables bacteria to evade the lethal effects of antibiotics, allowing them to thrive and multiply despite exposure.


Moreover, their rapid reproduction and ability to mutate grant them further resistance. Each successful mutation enhances their ability to survive higher concentrations and longer exposure times to antibiotics (Gostev et al., 2023). This poses a severe public health threat, particularly in treating infections associated with urinary catheters. These infections strain healthcare systems by complicating treatments, increasing costs, and causing life-threatening complications. Notably, SA is the leading cause of death in more than 100 countries. Antibiotic resistance in microbes isn’t just a buzzword—it’s a menacing reality shaping our healthcare landscape. Everyday infections can become life-threatening due to antibiotic-resistant SA. Our common skin microflora has now become a significant health challenge. Over the years, the prevalence of resistant strains has surged, complicating treatments and extending hospital stays. These aren’t abstract notions; they’re real-world scenarios. Picture a routine medical intervention, like inserting a urinary catheter, now carrying the risk of becoming a gateway for untreatable infections (Shrestha et al., 2019). These infections don’t just impact healthcare—they seep into the fabric of society. They make it harder for people, especially in low- and middle-income groups, to receive proper treatment (Ahmad & Khan, 2019). This issue affects communities' functionality, disrupting daily lives. Hospitals must juggle more, meaning other health issues might receive less attention. People may also avoid seeking medical help for fear of contracting hospital-associated infections. One issue leads to another. In short, antibiotic-resistant SA blurs the boundary between manageable and dire infections, demanding immediate action.


To address these issues, I wholeheartedly encourage readers to be responsible with antibiotic use, as this is the best solution for combating antibiotic resistance. Emphasizing the completion of prescribed antibiotic courses, rather than stopping once symptoms alleviate, is crucial. Public education campaigns should highlight this practice, outlining the risks of incomplete courses that foster resistant strains. Healthcare providers play a vital role in ensuring patients understand the importance of adhering to antibiotic courses throughout treatment. Additionally, implementing stringent antibiotic stewardship programs within healthcare facilities is imperative. These programs enforce strict antibiotic-prescribing practices, minimizing unnecessary antibiotic usage.


Another important approach is supporting the development of novel antibiotics and alternative therapies. Advances in technology allow scientists to synthesize new drugs both naturally and synthetically. Collaboration between scientific communities and pharmaceutical industries can drive innovation, creating effective treatments while reducing the likelihood of resistance emergence. Finally, advocating for policy reforms that promote responsible antibiotic use and research into novel antimicrobial agents is essential for a sustainable solution.


In conclusion, I urge readers to be responsible in their antibiotic consumption and to share the importance of completing prescribed antibiotics with family and friends. Sharing this knowledge helps spread the word about responsible antibiotic use. It’s about understanding that antibiotics are precious tools, not quick fixes. Taking them correctly and finishing the course is not just about personal health; it’s about safeguarding the well-being of everyone. By advocating for responsible antibiotic use, we create a chain of informed individuals who understand the broader impact of their actions. This responsibility is not just about one person—it’s a collective effort to preserve the effectiveness of antibiotics for future generations. It starts with each of us making informed decisions and spreading awareness.


References

Ahmad, M., & Khan, A. U. (2019). Global economic impact of antibiotic resistance: A review. Journal of Global Antimicrobial Resistance, 19, 313-316. https://doi.org/10.1016/j.jgar.2019.05.024


Arnold, B. J., Huang, I. T., & Hanage, W. P. (2022). Horizontal gene transfer and adaptive evolution in bacteria. Nature Reviews Microbiology, 20(4), 206-218. https://doi.org/10.1038/s41579-021-00650-4


Gostev, V., Kalinogorskaya, O., Sopova, J., Sulian, O., Chulkova, P., Velizhanina, M., ... & Sidorenko, S. (2023). Adaptive laboratory evolution of Staphylococcus aureus resistance to vancomycin and daptomycin: Mutation patterns and cross-resistance. Antibiotics, 12(5), 928. https://doi.org/10.3390/antibiotics12050928


Shrestha, L. B., Baral, R., & Khanal, B. (2019). Comparative study of antimicrobial resistance and biofilm formation among Gram-positive uropathogens isolated from community-acquired urinary tract infections and catheter-associated urinary tract infections. Infection and Drug Resistance, 957-963. https://doi.org/10.2147/IDR.S200988


Van Bambeke, F., Balzi, E., & Tulkens, P. M. (2000). Antibiotic efflux pumps. Biochemical Pharmacology, 60(4), 457-470. https://doi.org/10.1016/S0006-2952(00)00291-4


World Health Organization. (2023). Antimicrobial resistance expected to cause 5.2 million deaths in the Western Pacific by 2023. Retrieved from https://www.who.int/westernpacific/news/item/13-06-2023-antimicrobial-resistance-expected-to-cause-5.2-million-deaths-in-the-western-pacific-by-2030


 
 
 

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