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      A Review on Antibiotic Resistance: Alarm Bells are Ringing

      review-article
      1 , , 2 , 3 ,   4 , 5 , 6
      ,
      Cureus
      Cureus
      antibiotic resistance, knowledge, rational use

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          Abstract

          Antibiotics are the ‘wonder drugs’ to combat microbes. For decades, multiple varieties of antibiotics have not only been used for therapeutic purposes but practiced prophylactically across other industries such as agriculture and animal husbandry. Uncertainty has arisen, as microbes have become resistant to common antibiotics while the host remains unaware that antibiotic resistance has emerged. The aim of this review is to explore the origin, development, and the current state of antibiotic resistance, regulation, and challenges by examining available literature. We found that antibiotic resistance is increasing at an alarming rate. A growing list of infections i.e., pneumonia, tuberculosis, and gonorrhea are becoming harder and at times impossible to treat while antibiotics are becoming less effective. Antibiotic-resistant infections correlate with the level of antibiotic consumption. Non-judicial use of antibiotics is mostly responsible for making the microbes resistant. The antibiotic treatment repertoire for existing or emerging hard-to-treat multidrug-resistant bacterial infections is limited, resulting in high morbidity and mortality report. This review article reiterates the optimal use of antimicrobial medicines in human and animal health to reduce antibiotic resistance. Evidence from the literature suggests that the knowledge regarding antibiotic resistance in the population is still scarce. Therefore, the need of educating patients and the public is essential to fight against the antimicrobial resistance battle.

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          Most cited references31

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          An Enzyme from Bacteria able to Destroy Penicillin

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            Evolution and ecology of antibiotic resistance genes.

            A new perspective on the topic of antibiotic resistance is beginning to emerge based on a broader evolutionary and ecological understanding rather than from the traditional boundaries of clinical research of antibiotic-resistant bacterial pathogens. Phylogenetic insights into the evolution and diversity of several antibiotic resistance genes suggest that at least some of these genes have a long evolutionary history of diversification that began well before the 'antibiotic era'. Besides, there is no indication that lateral gene transfer from antibiotic-producing bacteria has played any significant role in shaping the pool of antibiotic resistance genes in clinically relevant and commensal bacteria. Most likely, the primary antibiotic resistance gene pool originated and diversified within the environmental bacterial communities, from which the genes were mobilized and penetrated into taxonomically and ecologically distant bacterial populations, including pathogens. Dissemination and penetration of antibiotic resistance genes from antibiotic producers were less significant and essentially limited to other high G+C bacteria. Besides direct selection by antibiotics, there is a number of other factors that may contribute to dissemination and maintenance of antibiotic resistance genes in bacterial populations.
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              Passive immunity in prevention and treatment of infectious diseases.

              Antibodies have been used for over a century in the prevention and treatment of infectious disease. They are used most commonly for the prevention of measles, hepatitis A, hepatitis B, tetanus, varicella, rabies, and vaccinia. Although their use in the treatment of bacterial infection has largely been supplanted by antibiotics, antibodies remain a critical component of the treatment of diptheria, tetanus, and botulism. High-dose intravenous immunoglobulin can be used to treat certain viral infections in immunocompromised patients (e.g., cytomegalovirus, parvovirus B19, and enterovirus infections). Antibodies may also be of value in toxic shock syndrome, Ebola virus, and refractory staphylococcal infections. Palivizumab, the first monoclonal antibody licensed (in 1998) for an infectious disease, can prevent respiratory syncytial virus infection in high-risk infants. The development and use of additional monoclonal antibodies to key epitopes of microbial pathogens may further define protective humoral responses and lead to new approaches for the prevention and treatment of infectious diseases.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                28 June 2017
                June 2017
                : 9
                : 6
                : e1403
                Affiliations
                [1 ] Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh
                [2 ] Projahnmo Study Site, Johns Hopkin's University Bangladesh
                [3 ] Health Consultant, Botane Skin Activates, Cape Town, South Africa
                [4 ] Department of Internal Medicine, MGM Medical College, Navi Mumbai, India
                [5 ] Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh
                [6 ] Department of Pharmacology, Dhaka Medical College, Dhaka, Bangladesh
                Author notes
                Article
                10.7759/cureus.1403
                5573035
                28852600
                0238f36b-e71c-4848-b028-ad3d07edbfb0
                Copyright © 2017, Zaman et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 16 June 2017
                : 28 June 2017
                Categories
                Epidemiology/Public Health
                Miscellaneous
                Epidemiology/Public Health

                antibiotic resistance,knowledge,rational use
                antibiotic resistance, knowledge, rational use

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