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The Epidemic Of Antibiotic-Resistant Infections: A Call To Action For The Medical Community From The Infectious Diseases Society Of America
The Epidemic of Antibiotic-Resistant Infections
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Today world is facing an emergent crisis of antibiotic resistance for microbial pathogens. These multidrug-resistant microbes are offering a considerable threat to US public health. Antibiotics usage has a critical role in the advanced medical treatment of patients. The development of antibiotics is linked with the development of advances in surgery. Infectious diseases are among the second-leading cause of death worldwide and the third-leading cause of death in the United States. The global spread of microbial resistance is a major cause of the spread of infectious diseases. This epidemic antibiotic resistance can be seen in numerous pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) infection, Streptococcus pneumoniae, and Mycobacterium tuberculosis ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"I8V1kgvK","properties":{"formattedCitation":"(Spellberg et al., 2008)","plainCitation":"(Spellberg et al., 2008)","noteIndex":0},"citationItems":[{"id":2504,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"itemData":{"id":2504,"type":"article-journal","title":"The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America","container-title":"Clinical infectious diseases","page":"155-164","volume":"46","issue":"2","author":[{"family":"Spellberg","given":"Brad"},{"family":"Guidos","given":"Robert"},{"family":"Gilbert","given":"David"},{"family":"Bradley","given":"John"},{"family":"Boucher","given":"Helen W."},{"family":"Scheld","given":"W. Michael"},{"family":"Bartlett","given":"John G."},{"family":"Edwards Jr","given":"John"},{"family":"America","given":"Infectious Diseases Society","dropping-particle":"of"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spellberg et al., 2008). These antibiotic-resistant microbes cause infections that have significant effects on clinicians practicing. The adaptability of these microbes is as diverse as human beings. These literally can inhabit every promising climate on the Earth such as boiling or freezing temperatures, extreme salinity as well as or absence of sunlight. This adaptability has taken nearly 3.5 billion years for microbes to adapt to the numerous atmospheres on planet Earth. The secret of this adaptability is genetic plasticity and rapid replication; bacteria need only 20–30 min to replicate ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"cVewox4f","properties":{"formattedCitation":"(Spellberg et al., 2008)","plainCitation":"(Spellberg et al., 2008)","noteIndex":0},"citationItems":[{"id":2504,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"itemData":{"id":2504,"type":"article-journal","title":"The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America","container-title":"Clinical infectious diseases","page":"155-164","volume":"46","issue":"2","author":[{"family":"Spellberg","given":"Brad"},{"family":"Guidos","given":"Robert"},{"family":"Gilbert","given":"David"},{"family":"Bradley","given":"John"},{"family":"Boucher","given":"Helen W."},{"family":"Scheld","given":"W. Michael"},{"family":"Bartlett","given":"John G."},{"family":"Edwards Jr","given":"John"},{"family":"America","given":"Infectious Diseases Society","dropping-particle":"of"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spellberg et al., 2008). This diverse adaptability of bacteria is stressing over the need for war with bacteria to save the human population.
Furthermore, this antibiotic resistance threat is requiring the use of new antibiotics that can combat this threat. In a war against microbes, antibiotics can serve as the most effective weapon. However, there is also an equally alarming decline in the research and development of new antibiotics. Reason for the decay of antibiotic development is multifactorial. IDSA, in partnership with the US FDA, circulated the first peer-reviewed data approving the drop in the progress of new antibiotics by pharmaceutical companies. The study was confirming the unquestionable decline of antibiotic development over the past 25 years. In the late 1960s, early antibiotic therapies got extraordinary success. US Surgeon General William H. Stewart at that time upon seeing a tremendous success claimed that there was no more need to continue the war against microbes. Unfortunately, his claim was wrong as genetic analysis of microbial metabolic pathways reveals the development of resistance by bacteria for b-lactam antibiotics and b-lactamase enzymes nearly 12 billion years back ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"dc8Fo5Q6","properties":{"formattedCitation":"(Spellberg et al., 2008)","plainCitation":"(Spellberg et al., 2008)","noteIndex":0},"citationItems":[{"id":2504,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"itemData":{"id":2504,"type":"article-journal","title":"The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America","container-title":"Clinical infectious diseases","page":"155-164","volume":"46","issue":"2","author":[{"family":"Spellberg","given":"Brad"},{"family":"Guidos","given":"Robert"},{"family":"Gilbert","given":"David"},{"family":"Bradley","given":"John"},{"family":"Boucher","given":"Helen W."},{"family":"Scheld","given":"W. Michael"},{"family":"Bartlett","given":"John G."},{"family":"Edwards Jr","given":"John"},{"family":"America","given":"Infectious Diseases Society","dropping-particle":"of"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spellberg et al., 2008). On the other hand, humans had not discovered antibiotics until the first half of the 20th century. Thus, microbes have nearly a mutual experience of producing and defeating antibiotics for 20 million times longer than Homo sapiens had discovered antibiotics.
Also, drug development is fronting cumulative challenges such as high costs. Moreover, antibiotics development is low as these have a lower relative rate of return on investment as compared to other drugs. Antibiotics are considered as short-course therapies as they are classically given for no more than two weeks ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"GX2tbvGP","properties":{"formattedCitation":"(Spellberg et al., 2008)","plainCitation":"(Spellberg et al., 2008)","noteIndex":0},"citationItems":[{"id":2504,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"itemData":{"id":2504,"type":"article-journal","title":"The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America","container-title":"Clinical infectious diseases","page":"155-164","volume":"46","issue":"2","author":[{"family":"Spellberg","given":"Brad"},{"family":"Guidos","given":"Robert"},{"family":"Gilbert","given":"David"},{"family":"Bradley","given":"John"},{"family":"Boucher","given":"Helen W."},{"family":"Scheld","given":"W. Michael"},{"family":"Bartlett","given":"John G."},{"family":"Edwards Jr","given":"John"},{"family":"America","given":"Infectious Diseases Society","dropping-particle":"of"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spellberg et al., 2008). Conversely, noncurative therapies are used to cure chronic diseases. Sometimes patients are required to take these drugs for the whole of their lives. Thus, venture capitalists and drug companies less wish to produce antibiotics. Another cause of decreasing antibiotic development is appropriate to use of broad-spectrum antimicrobials for public health. The more use of antibiotics make them less effective. However, this unavoidably damagingly sales by decreasing the use of antibiotics. With this, when physicians get new drugs in other classes available, they start using them. Pharmaceutical and biotechnology companies also point out another issue in the context of low antibiotic development. They are compliant about the dearth of accessible guidance documents from the FDA ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Ejd8NBTU","properties":{"formattedCitation":"(Spellberg et al., 2008)","plainCitation":"(Spellberg et al., 2008)","noteIndex":0},"citationItems":[{"id":2504,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"itemData":{"id":2504,"type":"article-journal","title":"The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America","container-title":"Clinical infectious diseases","page":"155-164","volume":"46","issue":"2","author":[{"family":"Spellberg","given":"Brad"},{"family":"Guidos","given":"Robert"},{"family":"Gilbert","given":"David"},{"family":"Bradley","given":"John"},{"family":"Boucher","given":"Helen W."},{"family":"Scheld","given":"W. Michael"},{"family":"Bartlett","given":"John G."},{"family":"Edwards Jr","given":"John"},{"family":"America","given":"Infectious Diseases Society","dropping-particle":"of"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spellberg et al., 2008). If they have these guidelines available, then it will significantly enhance the company's capacity to conduct antibiotic development.
Accordingly, the major cause of antibiotic resistance is the physician misapplication of antibiotics. The war against microbes can be won if physicians use antibiotics responsibly. For this, firstly, there is a need for suitable guidelines on the usage of antibiotics for viral infections as well as usage of antibiotics to enhance the development of food animals. Nevertheless, if physicians do not follow these guidelines, this can cause more microbial resistance. Society should understand "antimicrobial effectiveness" as a valuable and limited resource ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jY7ceHfi","properties":{"formattedCitation":"(Spellberg et al., 2008)","plainCitation":"(Spellberg et al., 2008)","noteIndex":0},"citationItems":[{"id":2504,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"itemData":{"id":2504,"type":"article-journal","title":"The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America","container-title":"Clinical infectious diseases","page":"155-164","volume":"46","issue":"2","author":[{"family":"Spellberg","given":"Brad"},{"family":"Guidos","given":"Robert"},{"family":"Gilbert","given":"David"},{"family":"Bradley","given":"John"},{"family":"Boucher","given":"Helen W."},{"family":"Scheld","given":"W. Michael"},{"family":"Bartlett","given":"John G."},{"family":"Edwards Jr","given":"John"},{"family":"America","given":"Infectious Diseases Society","dropping-particle":"of"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spellberg et al., 2008). This has the same effect as other limited resources, such as different energy sources, clean water, and air. Society has treaded in to guard them when the supply of these resources was susceptible. It should also stepped in and promote the antimicrobial effectiveness to protect this limited resource. Therefore, physicians should strictly use antibiotics only when truthfully specified. Contrariwise, if misuse of antibiotics is continued, then a time will come when using antibiotics appropriately will not halt microbial confrontation. Then the society would have developed resistance to all available antibiotics, and there will be no use of treatment with antibiotics.
To respond to this threat of antibiotic resistance, the Interagency Task Force has issued an "Action Plan to Combat Antimicrobial Resistance; Part 1: Domestic". This action plan has a total 84 action elements, of which 13 are at top priority ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"eGaUqs9h","properties":{"formattedCitation":"(Spellberg et al., 2008)","plainCitation":"(Spellberg et al., 2008)","noteIndex":0},"citationItems":[{"id":2504,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"itemData":{"id":2504,"type":"article-journal","title":"The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America","container-title":"Clinical infectious diseases","page":"155-164","volume":"46","issue":"2","author":[{"family":"Spellberg","given":"Brad"},{"family":"Guidos","given":"Robert"},{"family":"Gilbert","given":"David"},{"family":"Bradley","given":"John"},{"family":"Boucher","given":"Helen W."},{"family":"Scheld","given":"W. Michael"},{"family":"Bartlett","given":"John G."},{"family":"Edwards Jr","given":"John"},{"family":"America","given":"Infectious Diseases Society","dropping-particle":"of"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spellberg et al., 2008). Moreover, these elements are divided into four principal areas: surveillance, prevention and control, research, and product development. Regrettably, US federal agencies due to lack of resources have not been successful to satisfactorily implement the surveillance, prevention and control, and research elements of the Action Plan. Besides, the US government has also not proposed any additional measures to fuel research and development (R&D) of new antibiotics.
IDSA leaders during the last three years have taken aggressive strategies to highpoint the drug-resistance issue. They have also highlighted the need for new antibiotic R&D. their efforts include the publishing of major news stories, opinion, and editorial pieces. They had aimed to publicize the issue of antibiotic-resistant infections. The efforts to contest this threat are continued, and in 2004 the IDSA released a report, "Bad Bugs, No Drugs: As Antibiotic Discovery Stagnates, A Public Health Crisis Brews" ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"UDwOpWWL","properties":{"formattedCitation":"(Spellberg et al., 2008)","plainCitation":"(Spellberg et al., 2008)","noteIndex":0},"citationItems":[{"id":2504,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"itemData":{"id":2504,"type":"article-journal","title":"The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America","container-title":"Clinical infectious diseases","page":"155-164","volume":"46","issue":"2","author":[{"family":"Spellberg","given":"Brad"},{"family":"Guidos","given":"Robert"},{"family":"Gilbert","given":"David"},{"family":"Bradley","given":"John"},{"family":"Boucher","given":"Helen W."},{"family":"Scheld","given":"W. Michael"},{"family":"Bartlett","given":"John G."},{"family":"Edwards Jr","given":"John"},{"family":"America","given":"Infectious Diseases Society","dropping-particle":"of"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spellberg et al., 2008). The aim was to publicize the growing crisis of antibiotic-resistant infection and advise the US government on possible resolutions. Conversely, this exertion also failed, and no significant effort was made in response to this report. There is some progress on Capitol Hill that may make a possible improved practice of formerly developed antibiotics.
Moreover, IDSA members David Schlaes and Robert Moellering also in 2002released the public alert to the medical community related to the crisis of antibiotic development. This proved an effective alert and was trailed shortly by follow-up communications from IDSA. Different meetings were also held between the IDSA, the National Institutes of Health and the FDA ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"AVf0MHOf","properties":{"formattedCitation":"(Spellberg et al., 2008)","plainCitation":"(Spellberg et al., 2008)","noteIndex":0},"citationItems":[{"id":2504,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"itemData":{"id":2504,"type":"article-journal","title":"The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America","container-title":"Clinical infectious diseases","page":"155-164","volume":"46","issue":"2","author":[{"family":"Spellberg","given":"Brad"},{"family":"Guidos","given":"Robert"},{"family":"Gilbert","given":"David"},{"family":"Bradley","given":"John"},{"family":"Boucher","given":"Helen W."},{"family":"Scheld","given":"W. Michael"},{"family":"Bartlett","given":"John G."},{"family":"Edwards Jr","given":"John"},{"family":"America","given":"Infectious Diseases Society","dropping-particle":"of"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spellberg et al., 2008). Subsequently, this resulted in the establishment of “the Antimicrobial Availability Task Force." Its responsibilities were to develop recommendations for legislative and administrative action in addition to raising public consciousness about the issue. Likewise, IDSA has also motivated Congress and it has created legislation that could have address antimicrobial resistance and stimulate antibiotic R&D. The 110th US Congress has started to identify the stark nature of the antibiotic resistance disaster. In 2007, there came “the Food and Drug Administration Amendments Act of 2007”. It has an emphasis on refining the FDA’s capability to execute its perilous safety observing part for drugs, food as well as medical devices.
Likewise, the IDSA has established different strategies to check antimicrobial-resistant infections. There must be the establishment of a Federal Office of Antimicrobial Resistance in the Department of Health and Human Services. It should be responsible for synchronizing and funding the work of the Interagency Task Force to reinforce and implement the domestic Action Plan ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"4T6BKmaW","properties":{"formattedCitation":"(Spellberg et al., 2008)","plainCitation":"(Spellberg et al., 2008)","noteIndex":0},"citationItems":[{"id":2504,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"itemData":{"id":2504,"type":"article-journal","title":"The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America","container-title":"Clinical infectious diseases","page":"155-164","volume":"46","issue":"2","author":[{"family":"Spellberg","given":"Brad"},{"family":"Guidos","given":"Robert"},{"family":"Gilbert","given":"David"},{"family":"Bradley","given":"John"},{"family":"Boucher","given":"Helen W."},{"family":"Scheld","given":"W. Michael"},{"family":"Bartlett","given":"John G."},{"family":"Edwards Jr","given":"John"},{"family":"America","given":"Infectious Diseases Society","dropping-particle":"of"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spellberg et al., 2008). Moreover, a Public Health Antimicrobial Advisory Board must be developed that should include specialists in infectious diseases, hospital and community-based physicians. also, there is a dire need of establishment of an Antimicrobial Resistance Clinical Research and Public Health Network. It would be tracking and confirming the appearance of antibiotic-resistant pathogens in real-time.
The severity of the problem requires the implementation of diverse strategies. Immuno-enhancement is another complementary strategy to address the issue of antibiotic resistance. Different immunotherapies and immunoprophylactic strategies include vaccines and antibody-based therapies, and cytokines or other small molecules. This will lessen the inclusive affliction of infection and infection-related deaths ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"54irstLe","properties":{"formattedCitation":"(Spellberg et al., 2008)","plainCitation":"(Spellberg et al., 2008)","noteIndex":0},"citationItems":[{"id":2504,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/V35KABB9"],"itemData":{"id":2504,"type":"article-journal","title":"The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America","container-title":"Clinical infectious diseases","page":"155-164","volume":"46","issue":"2","author":[{"family":"Spellberg","given":"Brad"},{"family":"Guidos","given":"Robert"},{"family":"Gilbert","given":"David"},{"family":"Bradley","given":"John"},{"family":"Boucher","given":"Helen W."},{"family":"Scheld","given":"W. Michael"},{"family":"Bartlett","given":"John G."},{"family":"Edwards Jr","given":"John"},{"family":"America","given":"Infectious Diseases Society","dropping-particle":"of"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Spellberg et al., 2008). With the use of immunological strategies, the need for new antibiotics development can be eliminated from society. However, despite the use of vaccines and immunoglobulins for decades, practically no immune-based treatments are existing for common infections.
The only feasible and long-term solution to the difficulty of microbial resistance is stable development of new antibiotics. We cannot conquest microbial resistance, but we can only keep pace with it. For relevant legislation to be practicable, society must understand the severity of the issue. There must be the placement of suitable restrictions on antibiotic use. If physicians carefully use antibiotics, then they can get more time to make a real resolution to the issue. Antibiotic restoration must be promoted so there must not be further weakening of an already fragile market. Other strategies, such as the use of immunotherapeutic and vaccines must be promoted to enhance targeted therapy effectiveness. It takes years to progress with a new drug, thus, drug development requires careful planning.
References
ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Spellberg, B., Guidos, R., Gilbert, D., Bradley, J., Boucher, H. W., Scheld, W. M., … America, I. D. S. of. (2008). The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America. Clinical Infectious Diseases, 46(2), 155–164.
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