The Alphabet “A” Stands for Antimicrobial Resistance

The Alphabet "A" Stands for Antimicrobial Resistance

Ever since I was a small child, I have always hated taking drugs. The smell of drugs itself is a turnoff for me; it irritates me. If I am asked one thousand and one times to choose between injections and drugs, I will always go for injections. At least, I don’t get to perceive the horrible smell of the injection content. Taking drugs with just water has never been an easy task for me, if there is no pap or swallows that I will use to take the drugs, I would never use it. Putting drugs inside pap and swallows has been saving my life since the 00s.

Whenever I was sick and taken to the hospital, I would be given drugs. Instead of me to use to use the drugs, I would rather throw it away and pretended I use it. Even when I was being monitored, I would pretend I wanted to use it and threw it behind the sofa in our sitting room, except I was under strict monitoring and there was no choice than to use the drugs. Anytime I decided to use the drugs, I would stop whenever I felt I’m fine and would then discard the remaining ones. Before I knew it, I would fall sick in few months later and be diagnosed with typhoid (I was always diagnosed with typhoid) and this time, more severe than the previous. Most times, I would be admitted in the hospital and placed under monitoring for few days and will be discharged when I’m fine. Anytime I’m discharged, I would always thought I’m now fine and would not use the drugs given to me in the hospital. I could remember one day when drugs was bought for me when I was sick, despite being weak, I took pains to take the drugs from where it is kept and threw it behind the fence our house. That is the extent to which I hate drugs.

Little did I know that I was doing myself. I fell sick again and was taken to the hospital and and this time again, it was typhoid as usual, but this time more severe than all the previous episodes. All the medications given to me proved ineffective against the disease. It then dawned on me that the Salmonella has developed resistance to the drugs. Eventually, I was treated and was well again.

Ever since then, I started taking my drugs appropriately, completing my dosage regimen became a habit for me. Though, I still hate drugs and will always do, but “the fear of antimicrobial resistance is the beginning of wisdom”.

What then is Antimicrobial Resistance?

Antimicrobial Resistance (AMR) occurs when a microorganism develops resistance to antimicrobials (antibiotics, antivirals, antifungals and antiparasitic agents) that were used in killing it. When AMR occurs, microorganisms are no more susceptible to antimicrobials.

Left unchecked, antimicrobial resistance will roll back a century of medical progress, damage the environment, interrupt food production, cause people to fall into extreme poverty and imperil global health security. – Dr. Tedros Adhanam Ghebreyeus, Director General of the World Health Organization.

AMR is a serious global health threat; drug resistance anywhere is drug resistance everywhere. Approximately 700,000 deaths worldwide can be attributed to AMR each year, a figure that is poised to jump to 10 million by 2050 if actions are not taken to curb its spread.

The causes of AMR can be attributed to but not limited to the following :
Natural (Biological) Causes
Selective Pressure
In the presence of an antimicrobial, microbes are either killed or, if they carry resistance genes, survive. These survivors will replicate, and their progeny will quickly become the dominant type throughout the microbial population.


Most microbes reproduce by dividing every few hours, allowing them to evolve rapidly and adapt quickly to new environmental conditions. During replication, mutations arise and some of these mutations may help an individual microbe survive exposure to an antimicrobial.


Gene Transfer
Microbes also may get genes from each other, including genes that make the microbe drug resistant. Bacteria multiply by the billions. Bacteria that have drug-resistant DNA may transfer a copy of these genes to other bacteria. Non-resistant bacteria receive the new DNA and become resistant to drugs. In the presence of drugs, only drug-resistant bacteria survive. The drug-resistant bacteria multiply and thrive.

Societal Pressures
The use of antimicrobials, even when used appropriately, creates a selective pressure for resistant organisms. However, there are additional societal pressures that act to accelerate the increase of antimicrobial resistance.

Inappropriate Use
Selection of resistant microorganisms is exacerbated by inappropriate use of antimicrobials. Sometimes healthcare providers will prescribe antimicrobials inappropriately, wishing to placate an insistent patient who has a viral infection or an as-yet undiagnosed condition.

Inadequate Diagnostics
More often, healthcare providers must use incomplete or imperfect information to diagnose an infection and thus prescribe an antimicrobial just-in-case or prescribe a broad-spectrum antimicrobial when a specific antibiotic might be better. These situations contribute to selective pressure and accelerate antimicrobial resistance.

Hospital Use
Critically ill patients are more susceptible to infections and, thus, often require the aid of antimicrobials. However, the heavier use of antimicrobials in these patients can worsen the problem by selecting for antimicrobial-resistant microorganisms. The extensive use of antimicrobials and close contact among sick patients creates a fertile environment for the spread of antimicrobial-resistant germs.

Agricultural Use
Scientists also believe that the practice of adding antibiotics to agricultural feed promotes drug resistance. More than half of the antibiotics produced in the United States are used for agricultural purposes. However, there is still much debate about whether drug-resistant microbes in animals pose a significant public health burden.

Antimicrobial Resistance can be prevented by:
Stopping the Misuse of antibiotics
Not pressuring your healthcare professionals into prescribing antibiotics for you. Not all sickness require antibiotics.
Always practicing good hygiene.
Stopping indiscriminate and inappropriate use of antibiotics.


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