Article Information

Citation: Ewaoche Sunday Itodo, Andrew Nuhu Yashim. Antimicrobial Resistance: Misuse or Overuse of Antibiotics?. Archives of Veterinary Science and Medicine 6 (2023): 11-13.

DOI: 10.26502/avsm.036

Abstract

Keywords

Antimicrobial Resistance; Combinatorial Chemistry; Directed Synthesis; Diverse Molecular Target; R&D

Article Details

1. Introduction

Even after supposedly effective treatment, an infection may persist due to a variety of factors, including incorrect diagnosis, medication errors, rational drug selection, postulated treatment outcomes, drug interactions, potential adverse drug reactions, low immunity, and etiologic agent resistance to antibiotics [1].

There is a need for the development of more potent drugs if the persistence of infections is a key factor in antimicrobial agent resistance, which is the inability of microorganisms, particularly bacteria, fungi, parasites, and viruses, to withstand the effects of medications that were previously used to treat them. Antibiotic resistance (ABR) is the term for this type of medication resistance [2].

Drug-resistant superbugs are one of the biggest threats to your health, regardless of your socioeconomic status, race, gender, etc. Even though the issue is widespread, we are not completely helpless in the face of these formidable obstacles.

Globally about 700,000 people die each year from AMR representing about 1% of global death. It has been posited that by the year 2050, one out of every four deaths in Nigeria will be central to AMR. We are ostensibly on a cusp of a post antibiotics era. If the current trajectory of this drug resistance microorganisms is not reversed by 2050, some ten million people could succumb to drug resistance disease costing the global economy 20 trillion USD. I think your best defence is a healthy immune system [3].

2. True cause of AMR

If you are unable to identify the root cause(s) of this issue, it will be disappointing. First and foremost, Alexander Fleming identified Penicillium notatun, a typical mold, as the source of the first antibiotic in 1928. About ten years later, the medication was available, and it completely changed how infectious diseases were thought of. The synthesis of the drugs proved useful as the need for them grew. Penicillin's effectiveness against the Staphylococcus aureus for which it was developed significantly decreased because researchers used combinatorial chemistry and directed synthesis rather than the original materials upon which the drug was based. For instance, shortly after the massive production of the drug through combinatorial chemistry and directed synthesis in 1946, the efficacy of penicillin against S. aureus dropped to 88%. Four years later, the efficacy dropped to 66%. In 1982, it dropped to 10%, and now it is less than 5% sensitive to S. aureus [4] Can anyone hazard a guess that the total depletion in the efficacy of penicillin against S. aureus is a consequence of the overuse and misuse of antibiotics that have assumed a permanent cliché in our contemporary society today, when 128,000 people die each year in America because of taking medications as prescribed? Could it be the side effects of these chemically synthesized drugs? Would it have been different if the pharmaceutical industry had not totally embraced combinatorial chemistry and the direct synthesis of drugs?

Remember, Alexander Fleming gave a warning that bacteria are adaptive and that they will learn to get stronger, and eventually they will need stronger and stronger drugs. Could the active pharmaceutical product (API), excipients, or both have contributed to the rapid spread of this adaptation among microbes? Since there is a total shift from the micro program to combinatorial chemistry and directed synthesis, I can hazard a guess for the latter.

The most adaptable species is the one that endures, not the strongest or the most intelligent. Given that the nucleic acid, proteins, and cell wall that surround bacteria can all change, bacteria are genetically programmed to be adaptable. As long as the insults don't pile up or persist, some changes are temporary or reversible.

But if the insults are sustained or accumulate over time—and they can even be passed from one microbe to another—the change may also become permanent. Excipients or API are the main targets of the insults. This is because they are harmful to the body and can destroy the gut microbiome, which is where 80% of our immune system resides.

3. The panacea

The high cost of pharmaceuticals serves as an example of the failure of the current system. Over $5 billion is spent on one drug that takes about 15 years to develop [5 &6]. The process of creating new drugs is an open loop system that receives little input. This inefficient system creates medications that are only effective for a small subset of the target population while posing significant risks and side effects to the majority because drugs are not personalized [7].  This problem cannot be solved by simply increasing R&D expenditure.

The solution may lie in investing more in plant-based foods like medicinal plants, since they contain molecules that produce pharmacological effects similar to any other medication but with the advantage of having diverse molecular targets that prevent and correct the tendency toward disease without any palpable adverse effects.

Conflict of interest

The author declared that there was no conflict of interest.

References

1. Tolulope A, Ewaoche IS, Ibemologi A, et al., UreC and ZapA virulence genes amplification in clinical specimen of Proteus mirabilis in Bayelsa state, Nigeria. J Microbiol Exp 9 (2021): 15-20.
2. Dhingra S, Rahman NAA, Peile E, et al., Microbial Resistance Movements: An Overview of Global Public Health Threats Posed by Antimicrobial Resistance, and How Best to Counter. Front. Public Health 8 (2020): 535668.
3. Global Research on Antimicrobial Resistance (2022).
4. Chambers HF, Deleo FR. Waves of resistance: Staphylococcus aureus in the antibiotic era. Nature reviews. Microbiology 7 (2009): 629-641.
5. Willmann JK, van Bruggen N, Dinkelborg LM, et al., ‘Molecular imaging in drug development’, Nature Reviews Drug Discovery 7 (2008): 607.
6. Halpern BS, Longo C, Hardy D, et al., an index to assess the health and bene?ts of the global ocean. Nature 488 (2012): 615-620.
7. Woodcock J. The prospects for ‘personalized medicine, Drug Development and Drug Therapy 81 (2007):.64-169.