Antibiotic resistance occurs when bacteria evolve mechanisms that protect them from the effects of antibiotics. This is a major global health concern because it reduces the effectiveness of drugs that are essential for treating bacterial infections.
Consequences of Antibiotic Resistance
Increased morbidity and mortality – Infections that were once easily treatable become severe, leading to longer hospital stays and higher death rates.
Higher healthcare costs – More expensive second‑line or combination therapies are required, and patients often need prolonged treatment and intensive care.
Limited treatment options for surgeries and immunocompromised patients – Procedures such as organ transplants, chemotherapy, and major surgeries rely on effective prophylactic antibiotics.
Spread of resistant genes – Resistance genes can be transferred between bacterial species via plasmids, transposons, or bacteriophages, accelerating the emergence of multi‑drug‑resistant (MDR) strains.
Impact on agriculture and food security – Use of antibiotics in livestock promotes resistant bacteria that can be transmitted to humans through the food chain.
Key Examples of Resistant Pathogens
Pathogen
Common Resistance Mechanism
Clinical Impact
Staphylococcus aureus (MRSA)
Altered penicillin‑binding proteins (PBP2a)
Skin, bloodstream, and respiratory infections resistant to β‑lactams
Mycobacterium tuberculosis (MDR‑TB)
Mutations in rpoB and katG genes
Long‑term treatment with second‑line drugs; higher fatality
Escherichia coli (ESBL‑producing)
Extended‑spectrum β‑lactamases
Urinary and gastrointestinal infections resistant to cephalosporins
Neisseria gonorrhoeae
Efflux pumps & altered target enzymes
Untreatable sexually transmitted infections
Steps to Reduce the Impact of Antibiotic Resistance
Prudent prescribing practices
Prescribe antibiotics only when a bacterial infection is confirmed or highly suspected.
Choose the narrowest‑spectrum agent that is effective.
Adhere to recommended dose, duration, and route of administration.
Infection prevention and control (IPC)
Hand hygiene, sterilisation of equipment, and isolation of infected patients.
Vaccination programmes to reduce the incidence of bacterial diseases.
Antibiotic stewardship programmes
Multidisciplinary teams review antibiotic use and provide feedback to clinicians.
Use of electronic prescribing alerts and audit tools.
Public education and awareness
Inform patients about the importance of completing prescribed courses.
Discourage self‑medication and the use of leftover antibiotics.
Surveillance and monitoring
National and local databases track resistance patterns and antibiotic consumption.
Rapid diagnostic tests to identify pathogens and resistance genes.
Research and development
Incentivise the discovery of new antibiotics, alternative therapies (e.g., phage therapy), and vaccines.
Study mechanisms of resistance to design drugs that bypass them.
Regulation of antibiotic use in agriculture
Ban non‑therapeutic use of antibiotics as growth promoters.
Implement veterinary stewardship similar to human healthcare.
Suggested diagram: Flowchart showing the cycle of antibiotic use → selection pressure → emergence of resistant bacteria → spread → clinical consequences, with intervention points highlighted.
Summary
Antibiotic resistance threatens the effectiveness of modern medicine. By understanding its consequences and implementing a combination of prudent prescribing, robust infection control, public education, surveillance, and ongoing research, the impact of resistance can be mitigated.