Antimicrobial resistance: the global public health challenge

Abstract

Antimicrobial resistance is one of the biggest challenges faced by public health at the beginning of the third millennium. The global presence of antimicrobial resistance is threatening the continued effectiveness of many current medications. Antibiotic resistance is usually associated with significant morbidity, longer hospitalization, excess costs and mortality. Many factors contribute to the unnecessary use of antibiotics including the phenomenal knowledge boom, direct patient requests, perceptions of patient demand, culture and norms and advertisements and other promotional literature. Self-medication with antimicrobials is often cited as a major factor contributing to drug resistance. The microorganisms employ several mechanisms in attaining multidrug resistance such as they lack of reliance on the glycoprotein cell wall; enzymatic deactivation of antibiotics, decreased cell wall permeability to antibiotics and altered target sites of antibiotic. Efflux mechanisms to remove antibiotics and increased mutation rate are some of the other important mechanism for the antimicrobial resistance. Optimal use of existing antimicrobial agents, using alternative treatment options, reducing the need for antimicrobials by increasing immunity, education of health professionals and patients, antibiotic policies and implementation of infection control measures are the strategies aimed at prevention of emergence and spread of antibiotic resistance.