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How Can Antibiotic Resistance Be Prevented

Scientists Discover New Approach To Fighting Antibiotic Resistance

Combating Antibiotic Resistance: Infection Prevention & Control

by Conrad Duncan24 February 2022

A new approach to fighting antibiotic resistance could help to prevent diseases by making bacteria vulnerable to treatment again.

Researchers, including experts from Imperial College London, have found a way to impair antibiotic-resistant bacteria that cause human disease, such as E. coli, K. pneumoniae and P. aeruginosa, by inhibiting a protein that drives the formation of resistance capabilities within the bacteria.

Dr Despoina Mavridou, currently an assistant professor in Molecular Biosciences at the University of Texas at Austin, who led the research team, said the approach represented a completely new way of thinking about targeting resistance, which is a major health concern for scientists.

A study published in The Lancet in January found that antimicrobial resistance was the direct cause of at least 1.27 million deaths globally in 2019 and there are concerns about bacteria becoming increasingly resistant to existing antibiotics, with researchers struggling to identify new alternative drugs.

“Since the discovery of new antibiotics is challenging, it is crucial to develop ways to prolong the lifespan of existing antimicrobials.”Dr Chris FurnissDepartment of Life Sciences, Imperial College London

For their proof-of-concept study, published in the journal eLife, the researchers inhibited DsbA, using chemicals that cannot be used directly in human patients, to prevent the formation of resistance proteins.

Antibiotic Resistance Can Be Prevented Using Evolutionary Principles

Washington : The findings of new research suggested an effective way to kill bacteria and prevent its drug resistance. This was done by sequential treatment using antibiotics that are similar but swapped around frequently.

The results published in the journal in eLife challenge a broad assumption that using similar antibiotics promotes cross-resistance to drugs, and show that available antibiotics could offer unexplored, highly potent treatment options.

“We are currently in an antibiotic crisis, where the overuse of antibiotics is leading to increased antibiotic resistance and certain infections have become difficult and even impossible to treat,” said first author Aditi Batra, a graduate student at the Max Planck Institute for Evolutionary Biology and the University of Kiel, Germany.

Batra added, “It is the ability of pathogens to evolve and adapt to drugs that underlies this resistance, but evolutionary theory predicts that adaptation is difficult when the environment changes rapidly. We wanted to test if we could use sequential antibiotic treatment to slow down the evolution of human pathogens and limit drug resistance.”

The team used bacteria called Pseudomonas aeruginosa , which can cause pneumonia and other infections in humans. They tested three different sequences of antibiotics under laboratory conditions and measured their potency at killing off different sub-populations of evolved bacterial cells.

Can We Prevent Antibiotic Resistance

Antibiotics are losing effectivenessand millions are dying as a result. CARB-X, a BU-based partnership that aims to solve antimicrobial resistance, has been given up to $370 million in new funding from the US government and charitable foundation Wellcome

Antibiotics have saved countless lives since they were introduced in the 1940s, curing infections and making procedures like chemotherapy and surgeries safer. But their effectiveness is waning. As bacteria evolve, many have become resistant to antibiotics. An estimated 1.27 million people died worldwide in 2019 from infections caused by drug-resistant bacteria, according to a landmark study published in The Lancet. Its an estimated death toll that has nearly doubled in the past five years.

Since 2016, Boston University has been at the forefront of an international effort to combat antimicrobial resistance , leading CARB-X, a nonprofit partnership that channels funding and expertise to companies developing life-saving new antibiotics, vaccines, and rapid diagnostics.

CARB-Xs mission and global public-private partnership is filling a critical gap to help stem the AMR crisis, says BU President Robert A. Brown. We are grateful for the support of BARDA and Wellcome as researchers accelerate the discovery of new antibiotic classes around the world.

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Only Use Antibiotics For An Infection Caused By Bacteria

Antibiotics are effective against infections caused by bacteria. They don’t work against infections caused by viruses such as the common cold and the flu. Having green or yellow-coloured mucous, phlegm or snot isnt always a sign of a bacterial infection. Read more about snot and sputum. Symptoms such as cough, sore throat, earache and fever don’t always mean that you have a bacterial infection. While some people with these symptoms will need antibiotics, most people wont because the infection can be caused by viruses. In those cases, the infection will get better without antibiotics.

Strategies To Combat Antibiotic Resistance In Healthcare

Health Observation: Antibiotic Resistance at A Glance

The global nature of antibiotic resistance calls for a global response, both in the geographic sense and across the whole range of sectors involved. In line with a One Health approach, healthcare plays a central role in preventing the emergence and spread of antibiotic resistance.We all have to participate in this challenge!

  • to improve awareness and understanding of antimicrobial resistance
  • to strengthen knowledge through surveillance and research
  • to reduce the incidence of infection
  • to optimize the use of antimicrobial agents and
  • to develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.

The global nature of antibiotic resistance calls for a global response, both in the geographic sense and across the whole range of sectors involved. In line with a One Health approach, healthcare plays a central role in preventing the emergence and spread of antimicrobial resistance.We all have to participate in this challenge!

Promotion of awareness of all the stakeholders

Containment of bacterial transmission and prevention of infection

  • cut off any route of transmission.

Surveillance of healthcare-associated infections and antibiotic resistance

Antibiotic stewardship

Education for changing behavior

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Policy Reform Needed Too

Although CARB-Xs efforts to foster research and development are beginning to pay off, says Outterson, he believes sustained innovation needs to be supported by policy reform that pays for value rather than volume. Members of Congress are developing bipartisan legislation, the PASTEUR Act, which would function for antibiotics like Netflix does for movies, charging a subscription fee regardless of how many shows customers watch. Without the pressure to sell a high volume of drugs, companies could recover their upfront expenses and be incentivized to continue developing new antibiotics, while physicians would maintain good stewardship practices to slow the spread of resistance.

The best-informed estimate is that the world needs four breakthrough antibiotics every decade. The last new FDA-approved class of antibiotic against Gram-negative bacteria was discovered in 1962. Im 59 years old. Thats my lifetime, says Outterson. More than 30 therapeutics in our portfolio qualify as a new class. If any one of these makes it through, that will be the biggest antibiotic news in more than 60 years.

Take Unused Antibiotics To The Pharmacy For Safe Disposal

If you have leftover antibiotics from previous use, dispose of them correctly by returning them to your pharmacy for safe disposal. Don’t put them down the toilet or sink. There is a risk that antibiotics poured down the sink or flushed down the toilet may pass through treatment systems and enter rivers, lakes and even drinking water supplies. In homes that use septic tanks, antibiotics flushed down the toilet could leach into the ground and seep into ground water. Antibiotics that get into the environment may drive bacteria to become more resistant. Appropriate disposal of antibiotics by the pharmacy minimises this risk. Unused medicines taken to pharmacies are disposed of by specialist waste disposal companies.

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Preventing Antibiotic Resistance And The Spread Of Superbugs

Published on in CHOP News

According to estimates from the Centers for Disease Control and Prevention , more than half of the antibiotics used in the U.S. are prescribed unnecessarily or used improperly. The more we use antibiotics, the more likely it is that bacteria will adapt to them. The result: antibiotic resistant infections, or superbugs, which cause millions of illnesses and tens of thousands of deaths each year.

To combat this growing health crisis, many hospitals have created programs aimed at reducing the use of broad-spectrum antibiotics . These drugs target a wide range of disease-causing bacteria, which means they have the potential to create many types of bacteria that are antibiotic resistant.

Narrow-spectrum antibiotics, like penicillin and amoxicillin, target only the bacteria known to cause a specific bacterial infection. Using these narrow-spectrum antibiotics whenever possible helps prevent the development of antibiotic resistance.

The Childrens Hospital of Philadelphia wanted to help battle superbugs in outpatient settings, too. To do so, CHOP implemented an outpatient antimicrobial stewardship program in its primary care network. It is the first hospital to initiate a program like this.

The goal of the initiative is to encourage pediatricians to use antimicrobials appropriately and rely more on narrow-spectrum options which are recommended by national guidelines than broad-spectrum antibiotics.

Why You Should Care

Antimicrobial Resistance (AMR): What is it? How can we prevent it?

Antibiotic resistance has spread around the world, and it’s making some diseases, such as meningitis or pneumonia, more difficult to treat. You might need stronger, more expensive drugs. Or you might need to take them longer. You also might not get well as quickly, or you could develop other health issues.

Each year, an estimated 2.8 million people in the U.S. develop infections that are resistant to antibiotics, resulting in deaths of more than 35,000 people.

Resistance also makes it more difficult to care for people with chronic diseases. Some people need medical treatments like chemotherapy, surgery, or dialysis, and they sometimes take antibiotics to help reduce the risk of infection.

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Antibiotic Resistance Questions And Answers

Antibiotic resistance is one of the greatest public health challenges of our timefew treatment options exist for people infected with antibiotic-resistant bacteria.

Visit CDCs Antibiotic Resistance website for more information, including fact sheets describing some of these answers and how CDC is taking a One Health approach to combat this threat.

Ways To Prevent Antibiotic Resistance

The most important ways to prevent antibiotic resistance are:

  • Minimise unnecessary prescribing and overprescribing of antibiotics. This occurs when people expect doctors to prescribe antibiotics for a viral illness or when antibiotics are prescribed for conditions that do not require them.
  • Complete the entire course of any prescribed antibiotic so that it can be fully effective and not breed resistance.
  • Practise good hygiene such as hand-washing and use appropriate infection control procedures.

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What Do People Know

Numerous epidemiological studies on ABR have been undertaken in high- middle- and low-income countries. Most of these studies have been descriptive using cross-sectional surveys addressing questions such as awareness, knowledge, attitudes and practice.

A study across 12 countries was conducted in 2015 as part of the implementation of objective 1 of the WHO Global Action Plan to improve the awareness and understanding of AMR through effective communication, education and training. The study, which included 9,772 respondents, found that 65% had taken antibiotics during the prior 12 months, and 35% within the last month. The latter figure was 42% in low-income countries and 24% in people aged 65 years and older. Twenty-five percent of people across the 12 countries thought that it was acceptable to use antibiotics left-over from others and 32% reported that they generally stop taking antibiotics when they feel better. Two-thirds of the respondents believed that colds and flu can be cured with antibiotics. Some correct actions, such as regular hand-washing and only taking antibiotics when prescribed were acknowledged. The study revealed major misunderstandings regarding the meaning of ABR. While there was high awareness about increasing ABR , three quarters incorrectly believed that their body, rather than bacteria, become resistant to antibiotics. Many also held the view that it is only a problem for those who take antibiotics regularly .

How Does Antimicrobial Resistance Happen

Perspectives in Antibiotic Resistance

A microbe has five goals once it enters your body:

  • To reach the target site .
  • To attach to the target site.
  • To take nutrients from you, the host.
  • To avoid and/or survive any attacks by your immune system.

When you take an antimicrobial, the medication kills most of the microbes. But resistant microbes may survive.

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Spread Of Germs & Resistance Mechanisms

To survive, germs can develop defense strategies against antibiotics and antifungals called resistance mechanisms. DNA tells the germ how to make specific proteins, which determine the germs resistance mechanisms. Bacteria and fungi can carry genes for many types of resistance.

When already hard-to-treat germs have the right combination of resistance mechanisms, it can make all antibiotics or antifungals ineffective, resulting in untreatable infections. Alarmingly, antimicrobial-resistant germs can share their resistance mechanisms with other germs that have not been exposed to antibiotics or antifungals.

This table gives a few examples of defense strategies used to resist the effects of antibiotics or antifungals.

Can You Prevent Antibiotic Resistance

These steps may lower your risk of developing antibiotic resistance:

  • Only take antibiotics prescribed for you. Dont take someone elses medicine.
  • Follow your healthcare providers advice to treat your symptoms without antibiotics. Dont pressure your provider for an unnecessary prescription.
  • Set a reminder on your phone so you dont miss a dose. If you do forget to take your medicine, ask your provider what to do.
  • Take all of the medicine as prescribed, even if you feel better. If you stop an antibiotic too soon, bacteria can start to grow again, and they may develop resistance.
  • Wash your hands regularly. Good hygiene lowers your risk of getting a bacterial infection.

A note from Cleveland Clinic

Bacteria that develop antibiotic resistance dont respond to standard treatments. The result can be a bacterial infection thats difficult to treat. Antibiotic resistance is a worldwide health problem. To help prevent drug resistance, healthcare providers prescribe antibiotics only when needed. Overuse and misuse of antibiotics are top contributors to antibiotic resistance. Be sure to follow your providers instructions. Take antibiotics only when necessary and exactly as prescribed.

Last reviewed by a Cleveland Clinic medical professional on 06/23/2021.

References

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Bacteria Resistant To Antibiotics

Some bacteria have developed resistance to antibiotics that were once commonly used to treat them. For example, Staphylococcus aureus and Neisseria gonorrhoeae are now almost always resistant to benzyl penicillin. In the past, these infections were usually controlled by penicillin.The most serious concern with antibiotic resistance is that some bacteria have become resistant to almost all of the easily available antibiotics. These bacteria are able to cause serious disease and this is a major public health problem. Important examples are:

  • methicillin-resistant Staphylococcus aureus
  • carbapenem-resistant Enterobacteriaceae gut bacteria

How Can I Protect Myself And My Family From Antibiotic Resistance

How to prevent antibiotic resistance

No one can completely avoid getting an infection, but there are additional steps you can take to protect yourself and your family.

Protect yourself and your family from antibiotic resistance by

  • doing your best to stay healthy and keep others healthy,
  • cleaning hands,
  • staying home when sick, and
  • getting recommended vaccines, such as the flu vaccine.

Taking antibiotics only when they are needed is an important way you can protect yourself and your family from antibiotic resistance. Talk to your doctor about the best treatment if you are sick. Never pressure your doctor to prescribe an antibiotic.

When antibiotics arent needed, they wont help you, and their side effects could still cause harm. Ask your doctor or pharmacist about steps you can take to feel better when an antibiotic isnt needed.

If your doctor decides an antibiotic is the best treatment when you are sick:

  • Take the antibiotic exactly as your doctor tells you.
  • Do not share your antibiotic with others.
  • Do not save them for later. Talk to your pharmacist about safely discarding leftover medicines.
  • Do not take antibiotics prescribed for someone else. This may delay the best treatment for you, make you even sicker, or cause side effects.
  • Talk with your doctor and pharmacist if you have any questions about your antibiotics.

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Should You Finish A Course Of Antibiotics

Often you will feel better before your course of antibiotics is finished. More studies are showing that shorter courses of antibiotics are just as effective as longer courses. However, treatment guidelines are being updated with this new information, so your prescriber will take this into account when they decide your treatment. For some infections it is important to take antibiotics for a while after you feel better to make sure the infection is gone, so it is always best to complete your antibiotics as advised the prescriber. If in doubt, talk to your prescriber.

What You Can Do

To help fight antibiotic resistance and protect yourself against infection:

  • Don’t take antibiotics unless you’re certain you need them. An estimated 30% of the millions of prescriptions written each year are not needed. Always ask your doctor if antibiotics will really help. For illnesses caused by viruses — common colds, bronchitis, and many ear and sinus infections — they won’t.
  • Finish your pills. Take your entire prescription exactly as directed. Do it even if you start feeling better. If you stop before the infection is completely wiped out, those bacteria are more likely to become drug-resistant.
  • Get vaccinated. Immunizations can protect you against some diseases that are treated with antibiotics. They include tetanus and whooping cough.
  • Stay safe in the hospital. Antibiotic-resistant bacteria are commonly found in hospitals. Make sure your caregivers wash their hands properly. Also, ask how to keep surgical wounds free of infection.

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Using Evolutionary Principles Could Prevent Antibiotic Resistance

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Sequential treatment using antibiotics that are similar but swapped around frequently is an effective way to kill bacteria and prevent drug resistance, a study in eLife reports.

An agar plate with the human pathogen Pseudomonas aeruginosa and three antibiotics . Image credit: Roderich Roemhild

The results challenge a broad assumption that using similar antibiotics promotes cross-resistance to drugs, and show that available antibiotics could offer unexplored, highly potent treatment options.

We are currently in an antibiotic crisis, where the overuse of antibiotics is leading to increased antibiotic resistance and certain infections have become difficult and even impossible to treat, says first author Aditi Batra, a graduate student at the Max Planck Institute for Evolutionary Biology and the University of Kiel, Germany. It is the ability of pathogens to evolve and adapt to drugs that underlies this resistance, but evolutionary theory predicts that adaptation is difficult when the environment changes rapidly. We wanted to test if we could use sequential antibiotic treatment to slow down the evolution of human pathogens and limit drug resistance.

This study has been published as part of Evolutionary Medicine: A Special Issue from eLife. To view the Special Issue, visit .

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