ANTIBIOTIC RESISTANCE Aveen Omer Hawler College of Medicine/Kurdistan

What are antibiotics? The word antibiotic comes from the Greek anti meaning 'against' and bios meaning 'life‘ ' Antibiotics are also known as antibacterials. (a bacterium is a life form

Drugs used to treat infections caused by bacteria. An antibacterial is a compound or substance that kills or slows down the growth of bacteria

How Antibiotics work? Many mechanism: 1. inhibiting cell wall growth and synthesis. 2.Alter ribosomal function by inhibiting protein synthesis. 3. Interfere with replication of DNA or RNA. 1.>>>B-lactams>>> 2.>>>Aminoglycosides 3.>>>Quinolone

5. Disruption of the cell membrane permeability. 4. Drugs block the metabolic pathway essential for the life of the micro-organism. 5. Disruption of the cell membrane permeability. 4.>>>trimethoprim 5>>>polymyxins

What’s antibiotic resistance? Occurs when an antibiotic has lost its ability to effectively control or kill bacterial growth. The bacteria are "resistant" and continue to multiply in the presence of therapeutic levels of an antibiotic. …simply

How bacteria get resistance to Antibiotics?? Mechanisms: Production of drug-inactivation enzymes. Structural modification of antibiotic target site. Anaerobic bacteria are resistant to the actions of Aminoglycosides 1.>>> B-lactamase enzyme that destroys Pencillins and Cephalosporins. 2.>>>receptor protein on the 30s ribosomal subunit may be deleted or altered as some aminoglycosides can’t combine with the bacteria, as enterococci. 3.>>> absence of o2 dependant membranes

5. Development of alternative metabolic pathways. 4.Altered uptake of antibiotics>> resulting in decreased permeability, increased efflux. 5. Development of alternative metabolic pathways. 4.>>> gram –ve bacillus can induce some special proteins to block porin channels in cell wall, and prevnt the influx of tetracyclines. 5.>>> bac. Produce folic acid, by another pathway to become resistant to sulfonamides.

Why is antimicrobial resistance a global concern?

1. Antibiotic resistance kills. 2. Antibiotic resistance impedes the control of infectious agents. 3. with the problem of Antibiotic resistance progressing.. Threats increase to return to the pre-antibiotic era! 1.Some m.o. becoming resistance against antibiotics  resulting in prolonged illness and greater risk of death 2. AMR reduces the effectiveness of treatment because patients remain infectious for longer, thus potentially spreading resistant microorganisms to others. 3. Many infectious diseases risk becoming uncontrollable

4. Resistance of infectious agents to antibiotics, increases the costs of health care. 5. Jeopardizes health-care gains to society. 6. Threatens health security, and damages trade and economies. 4.When infections become resistant to first-line medicines, more expensive therapies must be used. The longer duration of illness and treatment, often in hospitals, increases health-care costs and the financial burden to families and societies. 5. The achievements of modern medicine are put at risk by AMR. Without effective antimicrobials for care and prevention of infections, the success of treatments such as organ transplantation, cancer chemotherapy and major surgery would be compromised. 6. The growth of global trade and travel allows resistant microorganisms to be spread rapidly to distant countries and continents.

Causes of Antibiotic resistance spreading; 1. Doctors who have become slave of habit. 2. prescribing>> without checking for the antibiotic sensitivity tests and also using broad spectrum antibiotics. 3. Cultural conceptions and patients demands. 4.Antibiotics are on the-counter drugs. q. Slave of habit: Doctors follow the old ways, it is easier to continue to treat the way you're used to than to absorb new information. Also, I think it's good to point out that a large proportion of medical school (especially during the AT and ST) is to learn from older colleagues. Therefore, there is some risk that we pick up bad habits of physicians who do not update their treatment if we are not on us andkeep us updated 3. Culture and the patient's requirements: Many patients "know" that antibiotics cureinfections, and if a doctor denies them that they go to someone willing to give them antibiotics. 3.Ppl not having the money to by the full dose of the drug or using low quality antibiotics

7.The enormous growth of global trade and travel 5. poverty 6. Patient compliance 7.The enormous growth of global trade and travel “Trade and travel have increased the speed and facility with which both infectious diseases and resistant microorganisms can spread between continents.” 4…Patient compliance: Finally, one should also mention that, although correct information was given and the drug is prescribed appropriately, there is a tendency in most countries not to do as you were told (people forget what you said, misunderstand references or just want orcan not eat medicine>>>easily underdose and develop resistance.

8.Antibiotic use in food production and animal care In several parts of the world, more than 50% in tonnage of all antimicrobial production is used in food-producing animals.

Finally, a picture that addresses the need for better sanitary conditions and that in that way can go far to counteract development of resistance. It is important to remember that preventive measures often cost less and are just as effective when working with health problems.

Changing word to actions Would you like to be a doctor in a world where there were no antibiotics??? --pls be with me and think about you…you being a doctor…patient comes to you with a dangerous infectious diss….but you can’t find a single antibiotic to prescribe for the patient to be cure?? Imagine the situation,,, feel the situation…would you, by any chance want that??? Well, we would not be more late to start action on the subject and do actual plans about it…..

For 1 moment…STOP…and..THINK…

What’s being done globally???

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React- Action on Antibiotic Resistance An international initiative with its base in Sweden Goal to reduce the development on antibiotic resistance www.reactgroup.org This page contains some brief info on React. *

START Student’s Targeting Antibiotic Resistance Today! PUTITNG A SOTP TO ANTIBIOTIC RESISTANCE!

PUTITNG A SOTP TO ANTIBIOTIC RESISTANCE!

An IFMSA group. Established>> December 2011 Cecilia Kållberg >>>Sweden Jannie Dressler >>>Denmark About 50 members, from 29 different countries!

START structure Webpage group Presentation/campaign group Article group  Connections to stakeholders Policy Statement group

Short-term goals: 1. To educate and raise awareness. To create awareness about the topic/ to educate people on the hazards of indiscriminate use of antibiotics. To prevent the consicuances.

2. To create material To create material that could be used by students when educating others To produce material that could be used beside presentations (posters etc.)

To share standard treatment guidelines amongst students at our universities To conduct a survey on physicians knowledge about antibiotics and antibiotic resistance (se point 3 on the agenda)

Long-term goals: 1.To engage other groups. To ask med faculties to add classes on the subject b. To ask hospitals to educate their employees also

How to start locally… 1.START>> gathering a group of interested students and members of IFMSA… also doctors 2.Activities>>Seminars, Workshops…etc. 3.Data collecting…surveys 

Thanx 