Edited by: Ana Budimir
ISBN Number: 978-953-56942-6-7
Expected Publishing Date: 01 Jun, 2018

Fighting Antimicrobial Resistance

by Ana Budimir

When antimicrobials were widely introduced in the 1940s they were considered as “miracle drugs” because they could successfully treat a broad range of common infections as well as more difficult bacterial diseases.

Since then, this medical innovation has saved millions upon millions of human lives around the globe. Due to overuse or misuse of antimicrobials, some bacterial strains have developed resistance to different antimicrobial drugs, although the antimicrobial resistance (AMR) is a natural process, some degree is expected to develop against all antimicrobials, even when treatments are optimal. It occurs when microorganisms evolve to be able to resist the medicine that has been used to combat them. Resistant microorganisms can survive or even grow in the presence of a concentration of antimicrobial that is usually sufficient to inhibit or kill non-resistant microorganisms of the same species. Medical doctors and scientists are alarmed that if the trend continues, we may enter a “post-antibiotic era” when even minor infections can prove fatal.

Antibiotics are among the most commonly prescribed drugs used in human medicine, but up to 50 % of the time antibiotics are not prescribed properly ( often given when not needed or with incorrect dosing or duration). Treatment failure caused by AMR contributes to: additional side effects; longer hospital stays; psychological disorders due to reduced quality of life; burden on families; and a greater likelihood of death as a result of inadequate or delayed treatment. AMR also affects patients who are not infected with resistant organisms. Infections caused by resistant organisms currently claim at least 50 000 lives each year across Europe and the USA, and hundreds of thousands of deaths are being caused in other areas of the world. AMR may be the greatest challenge to face health care in the 21st century.

While the development of AMR has been accelerating, the development of new antimicrobial agents has slowed substantially in past decades. For example, the ageing of the USA population has shifted medicine discovery efforts towards agents for chronic medical conditions that are more prevalent among the elderly, such as hypercholesterolaemia, hypertension, mood disorders, dementia, arthritis and cancer. Factors that will largely determine the future extent of AMR are: pathogen and microbial ecology; prescribing and dispensing practices; population characteristics; and health care policy.

Activities implemented in many countries contribute to AMR containment through increased capacities for improved infection prevention and control, stronger AMR stewardship, and the establishment of regulatory systems, national action plans, standard treatment guidelines, essential medicines lists, and updated pre-service curricula. It is important to build capacity, detection systems, and laboratories to strengthen and improve medicine use, improve infection prevention and control practices, and detect and report priority AMR pathogens.

The emergence of AMR is a complex problem driven by many interconnected factors, in particular the overuse and misuse of antimicrobials.

The aim of this book is to provide some perspective on this very important subject and to provide cutting-edge knowledge and reviews of the activities and various aspects of antimicrobial resistance containment.

The history of antimicrobial agents
Origin and development of antimicrobial drugs
Antibiotic and antimicrobial drugs
classes and types, the choice of antimicrobial drug
Design and discovery of novel antibiotics
Synthesis, chemistry, biotechnology
General principles of antimicrobial resistance in bacteria
Mechanisms and types of antimicrobial resistance
Enterobacteriaceae, Pseudomonas, Acinetobacter, Staphylococci, Vancomycin resistant enterococci (VRE) and principles of resistance in enterococci, Streptococcus pneumoniae and other streptococci, Neisseria , Chlamydiae, Mycoplasma and Ureaplasma
Antimicrobial susceptibility testing
Antimicrobial use in hospitals and general medicine practice
Antibitiotic stewardship
Antimicrobial use in veterinary medicine, food animals and food industry
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