Bacteria Drug resistance

As with bacteria, drug resistance in some parasites such as Plasmodium is a major problem and tends to appear where chemotherapy has been used extensively. This problem is exacerbated by the fact there are so few drugs available for the control of some parasites. Parasites utilize the same five basic resistance mechanisms that are displayed by bacteria 1) metabolic inactivation of the drug 2) use of efflux pumps 3) use of alternative metabolic pathways 4) alteration of the target 5) elevation of the amount of target enzyme. 

Li X-Z, Nikaido H (2004) Efflux-mediated drug resistance in bacteria. Drugs 64 159-204... 

Because the natural penicillins have been used for many years, drug-resistant strains of microorganisms have developed, making the natural penicillins less effective than some of the newer antibiotics in treating a broad range of infections. Bacterial resistance has occurred within tire penicillins. Bacterial resistance is the ability of bacteria to produce substances that inactivate or destroy the penicillin. One example of bacterial resistance is tiie ability of certain bacteria to produce penicillinase, an enzyme that inactivates penicillin. The penicillinase-resistant penicillins were developed to combat this problem. 

In the recently released book on worldwide compliance issues (Adherence to Long-term Therapies, Evidence for Action),7 published by the World Health Organization, researchers indicate that the problem of noncompliance is worse in countries in the developing world than in countries in the industrialized world. Many parts of the United States have similar morbidity and mortality rates as countries in the Third World.8 Specific disease states may have significant additional noncompliance ramifications due to the development of drug-resistant strains of bacteria.9 Many times what is necessary is referral to specific clinicians for individualized treatment and monitoring to enhance compliance. The case histories provided in this text will allow you to follow what others have done in similar situations to optimally help patients succeed in improving compliance rates and subsequent positive health outcomes. 

Gentamicin and tobramycin are equally effective. Tobramycin has slightly better MICs to Pseudomonas. Amikacin generally is reserved for multi-drug resistant bacteria. Typically used as a short course of therapy followed by a switch to an oral agent. 

Chitnis V, Chitnis D, Patil S, Kant R (2000) Hospital effluent as a source of multiple drug-resistant bacteria. Curr Sci India 79 989-991... 

In its report ( 3) issued in 1972, the Task Force acknowledged the potential human and animal health hazard of drug resistant bacteria and made a number of recommendations. In addition to basic research to better understand the nature of the problem, the Task Force recommended that restrictions be placed on the use of antibacterial agents in feeds which fail to meet guidelines established by the Task Force in regard to safety and/or efficacy. Agents that do not meet these standards would be prohibited from growth promotion and any subtherapeutic use in animals but could continue to be used at therapeutic levels for short-term treatment on the order of licensed veterinarians. 

R-plasmids can be transferred from normally nonpathogenic E. coli to certain pathogenic strains of bacteria with which they may come in contact in man or animals. Since R-plasmids carry drug resistance, this transfer can result in the creation of pathogenic strains of bacteria which are resistant to antibiotic therapy. 

Continued unrestricted subtherapeutic use of antibiotics in animal feed increases the pool of drug-resistant bacteria in our environment. Moreover, the prospect of pathogens becoming drug resistant is, as FDA believes, a real threat to human health. 

Practically all anaerobic Gram-negative bacteria are resistant to lincosamides. Resistance to lincosamides can occur because of the inability of drugs to permeate through the cellular membrane of bacteria, or because of changes in the ribosomal-binding regions. 

Resistance Prescribing tigecycline in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. 

Drug resistance To reduce the development of drug-resistant bacteria and maintain the efficacy of nitrofurantoin and other antibacterial drugs, only use nitrofurantoin to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. 

Because of the ultimate importance of vancomycin in the treatment of often fatal infections caused by multiple-resistant bacteria, extensive efforts have been directed toward the discovery of vancomycin derivatives with activity against these drug-resistant bacteria [89]. As a result of these efforts, several derivatives such as 41 (LY264826) have been found to be up to 500 times more effective than vancomycin itself. The most notable difference is the presence of another... 

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