Antibiotics are chemical substances obtained from certain non-pathogenic micro-organism (bacteria and fungi) and are used for either killing or inhibiting the growth of other pathogenic micro-organism without affecting the host tissue. For example, penicillins, cephalosporins, streptomycin, erythromycin gentamicin, tetracyclines, cotrimoxazole, ciprofloxacin etc.Misuse: The overuse of antibiotics like penicillin and erythromycin which used to be one-time miracle cure was in past, are now less effective. Random therapeutic usage of antibiotics in hospitals has been seen to be associated with increases in multi-antibiotic resistant bacteria.
The main ways of misuse of antibiotics are –
1.Individuals use the antibiotics randomly feeling just infected with minor or undefined infections.
2.The individual just use the antibiotics till they are sick and when they feel better leave the antibiotics without completing dose.
3. Doctor’s failure to take into accounts the patient's weight and history of prior antibiotic use when prescribing, since both can strongly affect the efficacy of an antibiotic prescription.
3.Individual failure to take the entire prescribed course of the antibiotic.
4.Doctor’s failure to prescribe or individual failure to take the course of treatment at fairly precise correct daily intervals (e.g. "every 8 hours" rather than merely "3x per day").
5.Individual failure to rest for sufficient recovery to allow clearance of the infecting organism.
6.Inappropriate antibiotic treatment is another common form of antibiotic misuse. A common example is the prescription and use of antibiotics to treat viral infections such as the common cold that have no effect.
The medical problem of bacterial drug resistance
Obviously, if a bacterial pathogen is able to develop or acquire resistance to an antibiotic, then that substance becomes useless in the treatment of infectious disease caused by that pathogen. So as pathogens develop resistance, we must find new (different) antibiotics to fill the place of the old ones in treatment regimes. Hence, natural penicillins have become useless against staphylococci and must be replaced by other antibiotics; tetracycline, having been so widely used and misused for decades, has become worthless for many of the infections that once designated it as a "wonder drug".
Prevention of Development of Resistance
The antibiotic resistance may be defined as the self protecting process for organisms that have enhanced ability to survive the antibiotics that would previously been lethal. Development of resistance may be limited by avoidance of indiscriminate use of antimicrobial drugs, appropriate selection of such drugs, constant monitoring of resistance pattern in community, and restricting use of newer antimicrobial drugs as long as currently used drugs as effective. A publicly sponsored antibiotic policy should incorporate—
1.Prevention of indiscriminate use
2. Appropriate combination to be used only when essential
3.Sensitivity pattern to be monitored at the community level.
4.Avoidance of indiscriminate use of newer antimicrobial drugs to be restricted.