Antimicrobial Resistance

Strategies for overcoming drug resistance in antimicrobial therapy
SCHOOL OF HEALTH & MEDICAL SCIENCES

ADAMAS UNIVERSITY
KOLKATA-700126
Prepared by: SAYANTAN KUNDU

(M.PHARM,PHARMACOLOGY)
Roll No.: PG/06/MPHARMP/2023/022
Enrollment No.: AU/2023/0010463
CONTENT
 INTRODUCTION
 FACTORS CONTRIBUTING
TO AMR
 MECHANISM OF AMR
 HOW AMR SPREAD
 RECENT APPROACHES TO
DOWNPLAYING AMR
 STRATEGIES TO COMBAT
ANTIBIOTIC RESISTANCE
Introduction
Anti Microbial resistance (AMR)
 Antimicrobial resistance (AMR) is an ability of a microorganism (bacteria, viruses and some parasites) to stop an
antimicrobials (antibiotics, antivirals, anti- malarials) from working against it.
 Any antimicrobial treatment becomes ineffective as infections persist and may spread to others.
 This is responsible for millions of death worldwide andis concerned as major public health concernnowadays.
Types
Factor contributing to Anti-Microbial resistance
 Environmental Factors  Drug Related Factors
1. Huge populations and overcrowding 1. Fake drugs.

2. Rapid spread - increased travelling 2. Quality of the drug.
3. Poor sanitation 3. Soaring use of antibiotics.
4. Increases community acquired resistance 4.Over the counter availability of antimicrobials.
 Patient Related Factors  Physician / Prescriber Related Factors
1. Poor adherence of dosage Regimens 1. Inappropriate use of available drugs.

2. Poverty. 2. Increased empiric poly-antimicrobial use.
3. Lack of sanitation concept. 3. Overuse of antimicrobials.
4. Lack of education. 4. Inadequate dosing.
5. Self-medication. 5. Lack of current knowledge and training.
6. Misconception.
Mechanism of Anti-microbial drug resistance
Enzymatic inactivation: An existing bacterial enzyme is modified to interact with an antibiotic in order to make them
inactive towards bacteria. It is due to the transfer of the antibiotic resistance gene carried on plasmids. The most significant
examples are beta-lactamase enzymes, which hydrolyze beta-lactams (penicillins, cephalosporins).
Drug extrusion by efflux pumps: These proteins, which are able to extrude a wide variety of compounds (including
antibiotics) out of the cell, are overexpressed by the bacteria to extrude the antibiotic. This is an important mechanism of
resistance in P. aeruginosa and Acinetobacter spp.
Decreased uptake by changes in the outer membrane permeability or by presence of porins: These variations
interfere with the entrance of antibiotics.
Modification of the drug target: These

changes impede the binding of the antibiotic and
limit its potency.
Recent Approaches for Downplaying Antibiotic Resistance:
Molecular Mechanisms
1. Cutting Edge Methodologies to Manipulate Antimicrobial Resistance
1.1. New Antibiotic discovery 1.2. Antibiotic Adjuvants for the Inhibition of
Resistance
2. Prioritized Other Modern and Novel Alternative Therapies
2.1 Antivirulent Therapy/Quorum-Sensing Inhibitors 2.3. Phage Therapy
2.2. Passive Immunization (Monoclonal Antibodies) 2.4. Nanoparticles

2.5. Phytochemicals 2.6. Vaccination
2.7. Antimicrobial Peptides

Call for action
Strategies to combat drug resistance in antibiotics:
International Measure National strategies:

1. Increased collaboration between 1. WHO recommends that such committee
governments, non-governmental would formulate AMR policy
organizations, professional groups and 2. Provide guidance on standards,
international agencies. regulations, training and awareness
2. New networks that undertake surveillance onantibiotic use and AMR.
of antimicrobials use of AMR. 3. Establishing and implementing national
3. International approach for control of standard treatment guideline, having
counterfeit antimicrobials. essential drug list (EDL)
4. Incentive for the research and development 4. National Antimicrobial Resistance Policy,
of new drugs and vaccines. India: To understand emergence, spreads
5. Forming new and reinforcing existing and factors influencing AMR, to setup
programmes to certain AMR antimicrobial program.
Action at Community level
Other Measures
1. Rational use of antibiotics.
2. Over-the-counter (OTC)
1. Improve and strengthen surveillance and
antibiotics.
3. Standards of hygiene. laboratory capacity and facilities
2. Make sure uninterrupted wide access to
Other Approaches essential medicines of assured quality

3. Regulate and encourage rational use of
1. Establishing an infection prevention and
control committee (IPC). medicines, even in animal husbandry, and
2. Good hand hygiene practices. ensure proper patient care.
3. Effective diagnosis and treatment of
infection 4. Improvise on infection prevention and control.
4. Surveillance of antibiotic resistance and 5. Promote and pursue innovations and research
antibiotic use.
5. Improving the antimicrobial quality and and development for new tools.
supply chain.
6. Good Microbiology Practices.
Conclusion
In conclusion, addressing antimicrobial drug resistance requires a multifaceted approach that encompasses
various strategies at both individual and societal levels. Through prudent antimicrobial use, enhanced
surveillance, development of new drugs, implementation of infection prevention and control measures, and
promoting public awareness, we can mitigate the growing threat of antimicrobial resistance. Collaboration
between healthcare professionals, researchers, policymakers, and the public is crucial to effectively combat this
global health challenge. By adopting comprehensive and sustainable strategies, we can preserve the
effectiveness of antimicrobial drugs and safeguard the health of current and future generations.
References
1. Ahmed S, Ahmed MZ, Rafique S, Almasoudi SE, Shah M, Jalil NA, Ojha SC. Recent approaches for
downplaying antibiotic resistance: molecular mechanisms. BioMed Research International. 2023 Jan 23;2023.
2. Holmes AH, Moore LS, Sundsfjord A, Steinbakk M, Regmi S, Karkey A, Guerin PJ, Piddock LJ. Understanding
the mechanisms and drivers of antimicrobial resistance. The Lancet. 2016 Jan 9;387(10014):176-87.
3. Fair RJ, Tor Y. Antibiotics and bacterial resistance in the 21st century. Perspectives in medicinal chemistry. 2014
Jan;6:PMC-S14459.
4. Tartari E, Abbas M, Pires D, De Kraker ME, Pittet D. World Health Organization SAVE LIVES: Clean Your
Hands global campaign—‘Fight antibiotic resistance—it's in your hands'. Clinical Microbiology and Infection.
2017 Sep 1;23(9):596-8.
5. Spellberg B, Guidos R, Gilbert D, Bradley J, Boucher HW, Scheld WM, Bartlett JG, Edwards Jr J, Infectious
Diseases Society of America. The epidemic of antibiotic-resistant infections: a call to action for the medical
community from the Infectious Diseases Society of America. Clinical infectious diseases. 2008 Jan 15;46(2):155-
64.
6. Cantón R, Morosini MI. Emergence and spread of antibiotic resistance following exposure to antibiotics. FEMS
microbiology reviews. 2011 Sep 1;35(5):977-91.
7. Liu YY, Wang Y, Walsh TR, Yi LX, Zhang R, Spencer J, Doi Y, Tian G, Dong B, Huang X, Yu LF. Emergence of
plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a
microbiological and molecular biological study. The Lancet infectious diseases. 2016 Feb 1;16(2):161-8.

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Strategies for overcoming drug resistance in antimicrobial therapy

SCHOOL OF HEALTH & MEDICAL SCIENCES

Prepared by: SAYANTAN KUNDU

Anti Microbial resistance (AMR)

 Environmental Factors  Drug Related Factors

1. Huge populations and overcrowding 1. Fake drugs.

 Patient Related Factors  Physician / Prescriber Related Factors

1. Poor adherence of dosage Regimens 1. Inappropriate use of available drugs.

Modification of the drug target: These

2.2. Passive Immunization (Monoclonal Antibodies) 2.4. Nanoparticles

2.7. Antimicrobial Peptides

International Measure National strategies:

Other Approaches essential medicines of assured quality

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