Several important factors can accelerate the evolution of drug resistance. These include the overuse and misuse of antimicrobials, inappropriate use of antimicrobials, subtherapeutic dosing, and patient noncompliance with the recommended course of treatment.
Full Answer
What is antibiotic resistance?
Antibiotics are drugs used for treating infections caused by bacteria. Also known as antimicrobial drugs, antibiotics have saved countless lives. Misuse and overuse of these drugs, however, have contributed to a phenomenon known as antibiotic resistance.
What is drug resistance and how does it occur?
Introduction Drug resistance is a well-known phenomenon that results when diseases become tolerant to pharmaceutical treatments. This concept was first considered when bacteria became resistant to certain antibiotics, but since then similar mechanisms have been found to occur in other diseases, including cancer.
What causes resistance to anti-TB drugs?
Resistance to anti-TB drugs can occur when these drugs are misused or mismanaged. Examples include when patients do not complete their full course of treatment; when health-care providers prescribe the wrong treatment, the wrong dose, or length of time for taking the drugs; when the supply of drugs is not always available;
How can we solve the problem of drug resistance?
Many interventions to address the problem of resistance are the same as those that reduce the burden of disease (these are discussed in detail in the relevant disease-specific chapters in this volume). Reducing disease diminishes the need for drug treatment and, therefore, lowers the likelihood that resistant strains will emerge.
How does drug-resistant TB develop?
Drug-resistant TB (DR TB) is spread the same way that drug-susceptible TB is spread. TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings.
When should one suspect the possibility of drug-resistant TB?
Up to 90% of all patients who fail treatment, defined as a positive AFB sputum smear or culture after 5 months of therapy, will have MDR-TB strains. Given this, patients who remain smear positive after 3 months of treatment should be investigated for possible drug-resistant TB.
What circumstances have led to the spread of drug-resistant tuberculosis?
The spread of drug resistance stems from many factors: poor public health infrastructure (e.g., delays in the diagnosis of drug resistance, inconsistencies in TB medication supply), inadequate treatment (e.g., unmonitored therapy, nonadherence, incorrect use of anti-TB agents), inefficient infection control, and the ...
Which method was developed to help prevent the development of drug-resistant TB by watching a patient take his or her medication?
Bacillus Calmette–Guérin (BCG) vaccination prevents severe forms of TB in children and may have a protective effect against lung disease among children and adults (although estimates of efficacy for pulmonary disease greatly vary).
What is medication resistance?
Drug resistance is the reduction in effectiveness of a medication such as an antimicrobial or an antineoplastic in treating a disease or condition. The term is used in the context of resistance that pathogens or cancers have "acquired", that is, resistance has evolved.
Why is drug resistance a problem?
Antibiotic resistance leads to higher medical costs, prolonged hospital stays, and increased mortality. The world urgently needs to change the way it prescribes and uses antibiotics. Even if new medicines are developed, without behaviour change, antibiotic resistance will remain a major threat.
How can the development of multidrug resistant tuberculosis be minimized in patients?
The most important thing a person can do to prevent the spread of MDR TB is to take all of their medications exactly as prescribed by their health care provider. No doses should be missed and treatment should not be stopped early.
Why has it become more difficult to treat TB over time?
Scientists have assumed that mycobacteria are so hard to kill because dormant cells exist even in patients with active disease and these cells are far less susceptible to antibiotics than metabolically active bacteria.
How common is drug-resistant TB?
According to the report, approximately 20% of TB cases globally are estimated to be resistant to at least one of the first- or second-line anti-TB drugs, and 5% are resistant to both isoniazid and rifampicin, the most powerful and commonly used antibiotics in first-line treatment.
What are some important ways to prevent exposure to TB?
Protect your family and friends from TB – take ALL your TB drugs!Who Should be Tested.Testing for TB Infection.Testing in BCG-Vaccinated Persons.TB Screening and Testing of Health Care Personnel.Testing During Pregnancy.Diagnosing latent TB infection and TB disease.
Why is it important to complete TB treatment?
Taking medication for 6 months is the best way to ensure the TB bacteria are killed. If you stop taking your antibiotics before you complete the course or you skip a dose, the TB infection may become resistant to the antibiotics.
What is the treatment for drug resistant TB?
Ideally, all patients with MDR-TB should have DST to a fluoroquinolone, and, if an injectable is to be used, DST to second-line injectable (SLI) agents. Ideally, DST for bedaquiline, delamanid, linezolid, and pyrazinamide should be performed.
What Is Tuberculosis (TB)?
Tuberculosis (TB)(https://www.cdc.gov/tb/publications/factsheets/general/tb.htm) is a disease caused by bacteria that are spread from person to per...
What Is Multidrug-Resistant Tuberculosis (MDR TB)?
Multidrug-resistant TB (MDR TB) is caused by an organism that is resistant to at least isoniazid and rifampin, the two most potent TB drugs. These...
What Is Extensively Drug Resistant Tuberculosis (XDR TB)?
Extensively drug resistant TB (XDR TB) is a rare type of MDR TB that is resistant to isoniazid and rifampin, plus any fluoroquinolone and at least...
How Does Drug Resistance Happen?
Resistance to anti-TB drugs can occur when these drugs are misused or mismanaged. Examples include when patients do not complete their full course...
Who Is at Risk For Getting MDR TB?
Drug resistance is more common in people who: 1. Do not take their TB medicine regularly 2. Do not take all of their TB medicine as told by their d...
How Can MDR TB Be Prevented?
The most important thing a person can do to prevent the spread of MDR TB is to take all of their medications exactly as prescribed by their health...
Is There A Vaccine to Prevent TB?
Yes, there is a vaccine for TB disease called Bacille Calmette-Guérin (BCG)(https://www.cdc.gov/tb/publications/factsheets/prevention/bcg.htm). It...
What Should I Do If I Think I Have been Exposed to Someone With TB Disease?
If you think you have been exposed to someone with TB disease, you should contact your doctor or local health department about getting a TB skin te...
What Are The Symptoms of TB Disease?
The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of TB disease of th...
What is the FDA's role in antibiotic resistance?
In cooperation with other government agencies, the Food and Drug Administration (FDA) has launched several initiatives to address antibiotic resistance. The agency has issued drug labeling regulations, emphasizing the prudent use of antibiotics. The regulations encourage health care professionals to prescribe antibiotics only when clinically ...
What are some examples of bacteria resistant to antibiotics?
Examples of the types of bacteria that have become resistant to antibiotics include those that cause skin infections, urinary tract infections, meningitis, sexually transmitted diseases and respiratory tract infections such as pneumonia. In cooperation with other government agencies, the Food and Drug Administration ...
Why do we need antibiotic labeling?
Antibiotic labeling contains required statements in several places advising health care professionals that these drugs should be used only to treat infections that are believed to be caused by bacteria. Labeling also encourages health care professionals to counsel patients about proper use.
What is the term for the disease that occurs when bacteria change in a way that reduces or eliminates the effectiveness
Misuse and overuse of these drugs, however, have contributed to a phenomenon known as antibiotic resistance. This resistance develops when potentially harmful bacteria change in a way that reduces or eliminates the effectiveness of antibiotics.
When is it important to take antibiotics?
When you are prescribed an antibiotic to treat a bacterial infection, it's important to take the medication exactly as directed. Here are more tips to promote proper use of antibiotics. Take the antibiotics as prescribed. It's important to take the medication as prescribed by your doctor, even if you are feeling better.
Why don't you need antibiotics?
Learn more about why you may not need antibiotics when you're sick and the problems antibiotics can cause if taken unnecessarily. Antibiotics are drugs used for treating infections caused by bacteria. Also known as antimicrobial drugs, antibiotics have saved countless lives. Misuse and overuse of these drugs, however, ...
When did the FDA approve antibiotics?
Approval of certain new antibiotics. Since 2015, FDA approved new antibiotics that can treat certain resistant bacteria. Health care professional are encouraged to use the new antibiotics appropriately and for some antibiotics, use only in patients who have limited or no other treatment options.
What to do if you are not following through on a drug?
If you find yourself tempted not to follow through on your treatment, contact your doctor to share your reasons, and together, to the extent it's possible, work out an alternative you both can agree on.
Why don't patients follow treatment plans?
Reasons Patients Don't Comply. Research published in 2011 suggests that some of the main reasons patients do not adhere to treatment plans include: 5 . Denial of the problem: Many diseases and conditions are easy to ignore, even when they have been diagnosed. This is particularly true for diseases that are asymptomatic, ...
How to keep a medicine calendar?
Keep a "medicine calendar" near your medicine: Make a checkmark every time you take your dose. Tell your doctor if paying for prescription drugs is a problem: Your doctor may be able to prescribe a generic medication or offer other suggestions to offset the cost of a drug. (Generic drugs can cost 80 to 85% less .)
What happens if you don't follow through with your doctor?
Needless to say, when patients don't follow through with the treatment decisions they have made together with their physicians, it can cause additional problems. They may not get over their sickness or injury. They may get even sicker or injure themselves further—or worse.
Do kidney transplant patients take anti-rejection medications?
Even those at high risk of serious complications often resist following treatment regimens. A 2016 study found that a third of kidney transplant patients don’t take their anti-rejection medications. 3 An estimated 50% of patients with cardiovascular disease and its major risk factors have poor adherence to prescribed medications. 4 .
Can you take prescriptions as directed 2021?
Updated on February 24, 2021. It may seem obvious, even non-negotiable, that if your doctor gives you a prescription, you'll have it filled by your pharmacist and you'll take it as directed; if he or she gives you a referral to a specialist or recommends lifestyle changes, you'll follow through.
Can you be reluctant to take a medication after reading about the side effects?
Also, patients may be reluctant to start a medication after reading about the possible side effects.
A Public Health Issue
- Antibiotic resistance is a growing public health concern worldwide. When a person is infected with an antibiotic-resistant bacterium, not only is treatment of that patient more difficult, but the antibiotic-resistant bacterium may spread to other people. When antibiotics don't work, the result can be 1. longer illnesses 2. more complicated illnesse...
Antibiotics Fight Bacteria, Not Viruses
- Antibiotics are meant to be used against bacterial infections. For example, they are used to treat strep throat, which is caused by streptococcal bacteria, and skin infections caused by staphylococcal bacteria. Although antibiotics kill bacteria, they are not effective against viruses. Therefore, they will not be effective against viral infections such as colds, most coughs, many ty…
Follow Directions For Proper Use
- When you are prescribed an antibiotic to treat a bacterial infection, it's important to take the medication exactly as directed. Here are more tips to promote proper use of antibiotics. 1. Take the antibiotics as prescribed.It's important to take the medication as prescribed by your doctor, even if you are feeling better. If treatment stops too soon, and you become sick again, the remai…
What FDA Is Doing
- FDA combating antibiotic resistance through activities that include 1. Approval of certain new antibiotics. Since 2015, FDA approved new antibiotics that can treat certain resistant bacteria. Health care professional are encouraged to use the new antibiotics appropriately and for some antibiotics, use only in patients who have limited or no other treatment options. 2. Labeling regul…