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Zafir Khan
Mrs. Chao
WRITING 10-8D
1 May 2015
Solutions to Antimicrobial Resistance
The establishment of antimicrobials in the late 1890s has been beneficial throughout the
world for not only humans, but animals and plants as well. Antimicrobials are a form of
medicine that alleviates the symptoms of a microbial infection by preventing the microbe to
grow and survive in the host organism, being the person or animal infected. The way
antimicrobials function is that they act by degrading the microbial cell wall, which ultimately
results in the death of the microorganisms. Since antimicrobials were established, the symptoms
of caused by various lethal bacteria were able to be alleviated. The issue that the public health
community has been facing over the last thirty years is that more and more microbes are
becoming resistant to various antimicrobials. The World Health Organization stated that,
“Antimicrobial resistance threatens the effective prevention and treatment of an ever-increasing
range of infections caused by bacteria, parasites, viruses and fungi” (Antimicrobial Resistance).
This is a major concern as there has been an increasing number of deaths due to microbial
infections. There are certain microbes that are always killed off by antimicrobials, yet as the
incorrect usage of antimicrobials increase, more and more microorganism have become resistant
to antimicrobials. The mechanism of a microbe attaining antimicrobial resistance is actually
quite simple. The World Health Organization stated that, “the evolution of resistant strains is a
natural phenomenon that occurs when microorganisms replicate themselves erroneously or when
resistant traits are exchanged between them” (Antimicrobial Resistance). Antimicrobials are
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prescribed daily to patients across the United States, and used substantially in agriculture. In
agriculture, farmers have implemented the usage antimicrobials to crops and animals to increase
size and output. Farmers and everyday individuals can obtain antimicrobials from drug stores
and agricultural based stores without a prescription. “The potent and more expensive
antimicrobials require prescription, however in the case of agriculture, most antimicrobials are
available without prescription” (CDC). It is important to implement a system in which
antimicrobial distribution is monitored and limited. By limiting the distribution and unnecessary
usage of antimicrobials in a hospital/clinical and agricultural setting, the increase in antibiotic
resistance can be reduced, as well as prevented.
The over distribution of antimicrobials in hospitals and clinical settings by physicians are
a major reason in why antimicrobial resistance has increased. As more and more microbial
infections occur, there is a greater need and demand for effective antimicrobials. The United
States Center for Disease Control and Prevention noted that, “more than two million people in
the U.S. get drug-resistant infections annually” (CDC). There are various reasons for why
hospitals are a major source for increasing antimicrobial resistance. For instance, when a parent
brings his/her child to visit the doctor regarding the condition of the child, the parent expects to
leave with some form of medication. “The truth of the matter is that most of the time the child
has a fever or some mild illness in which there is no need for antimicrobials” (Antibiotic
Resistance Solutions Initiative). The parent demands that the child receives medication, and thus
the physician is more inclined and pressured into prescribing antibiotics. This will only aid in
microbes becoming more and more resistant to antimicrobials. According to the CDC,
“pediatricians have also urged doctors to avoid giving antibiotics unless it is absolutely
necessary, especially for ear infections and sinusitis” (CDC). This statement is not made to make
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it where physicians should never prescribe antimicrobials, but limit the practice of prescribing
antimicrobials to only when it is required. The reason for this is that a microbe can become
resistant upon being treated with antimicrobial that is not effective against it. This results in
infectious diseases that cannot be treated, which results in the deaths of individuals. By making
sure a patient only receives antimicrobials when he/she has a microbial infection will limit the
spread and increase of microbial infection. Each time antimicrobial is used incorrectly, the
microbes in the environment become more and more resistant to the given antimicrobials. In
addition, it has been observed that patients most often will not complete the full dosage
prescribed to them by their physician. The patient will start to see the symptoms caused by the
microbe to fade, yet the microbe will not entirely die off. Thus this microbe will become resistant
to the bacteria and reproduce. However, the main area of concern is prescribing the correct
antimicrobial. According to the CDC, “up to 50 percent of antibiotics are prescribed incorrectly
or to people who do not need them” (CDC). This is the major reason in why there needs to be a
restriction on the amount of antimicrobials that can distributed, as well as an effective system in
making the patient and parents understand that they do not need antimicrobials. It is very
important for the medical community to educate and make the patient understand what
antimicrobials are actually used for, as well as educating physicians on how to react when they
are pressured into a situation in which the parent of a child is demanding some form of
medication. In addition, the “development of next generation rapid susceptibility tests for drugresistant microbes” should be established in order to not only prevent unnecessary usage of
antimicrobials, but prevent an epidemic (Antibiotic Resistance Solutions Initiative). With a
system that makes patients understand the importance of only using antimicrobials when they
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have microbial infections, as well as understanding to take the full dosage of the prescribed
antimicrobials, a future in which antimicrobial resistance is drastically low can be reached.
In addition, antimicrobials have been excessively used in agriculture on crops and
animals, which have played a prominent role in the increase in antimicrobial resistance. Most of
the antimicrobials that are produced for agricultural and animal usage are available over the
counter in most drug stores. According to the CDC, “the 2013 Threats report points out that
according to data published by FDA, there are more kilograms of antibiotics sold in the United
States for food-producing animals than for people. This use contributes to the emergence of
antibiotic-resistant bacteria in food-producing animals” (Antibiotic Resistance Foodborne and
Germs). This is alarming as most of the food humans consume on a daily basis comes from an
agricultural setting. The animals that are grown on farms are subjected to antimicrobials as well.
This only furthers antimicrobial resistance, as these crops and animals acts as carriers which
transfer the antimicrobials into the immune systems of microbes. This is similar to physicians
prescribing incorrect antimicrobials, as in this case the unnecessary antimicrobials will be
processed by the microbes, which will give rise to the further development of antimicrobial
resistance. Resistant bacteria can contaminate the foods that come from animals that serve as
carriers of resistant bacteria, and people who consume these foods can develop antibioticresistant infections” (Antibiotic Resistance Foodborne and Germs). By consuming foods that
have had antimicrobials administered to them, the spread of antimicrobial resistance is further
spread. Microbes evolve and thus diversify among their various habitats, which make it very
easy for them to evolve and adapt when exposed to an incorrect antimicrobial is administered to
them. It is important to implement a system in which there are multiple restrictions on
purchasing antimicrobials for plants and animals. The CDC mentions that “antibiotics that are
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medically important to treating infections in humans should be used in food-producing animals
only under veterinary oversight and only to manage and treat infectious diseases, not to promote
growth” (Antibiotic Resistance Foodborne and Germs). Since the availability for antimicrobials
for crops and animals have been increased, the increase in people with microbial infections have
also increased. For instance, the microbe listeria is commonly found in yogurt and ice cream. In
2010, there was an outbreak of listeria in Blue Bell frozen desserts. “148 people were reported
with being infected, and 48 people died from that infection due to the fact there was no effective
antimicrobial available at the time” (Antibiotic Resistance Threats Report and Foodborne
Germs). After investigation, it was noted that the cows that the ice cream was produced from had
had antimicrobials administered to them. Thus the products acted as carriers, which gave rise to
the antimicrobial resistance of listeria. Pharmaceutical companies were later able to produce an
effective antimicrobial to kill off listeria, yet it was too late. This is a major reason in why there
needs to be restrictions on the usage of antimicrobials in food and crops, as a microbial outbreak
could have been prevented. To prevent and limit the spread of antimicrobial resistance in
agriculture, the United States should adopt a model similar to Sweden, and other European
countries as Norway. “Agriculture in Sweden is more industrialized and there's more movement
of food and animals across the borders. The Norwegian agriculture policy decreases the risk of
developing resistant bacteria and a small import of animals and food create less spread of
resistant microbes” (Sweden). The systems that are established in Sweden and most European
countries are to educate farmers all over the country, and explain that agricultural output and
financial profit will not decrease due to decreasing the usage of antimicrobials. This is very
important, as “70% of infectious diseases in humans originate from animals”. (Sweden) Sweden
and Norway have effectively lowered the annual rate of people dying from microbial infections.
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The system will educate farmers and any individual that desires to use antimicrobials to produce
crops and animals that antimicrobials cause more harm than good. The system also restricts the
amount of antimicrobials being distributed to a farmers, as well as annual inspections. It will be
daunting task to convince farmers to decrease and even stop using antimicrobials on their crops
and animals, yet by showing statistics and a model that actually works, the farmers should be
inclined to follow the guidelines and principles of the system.
Since the establishment of antimicrobials, humankind has benefited a great deal from
using antimicrobials to treat microbial infections. However, due to over using and incorrectly
using antimicrobials, microbes have evolved and developed resistance to an array of
antimicrobials. This has proved to be a major public health concern throughout the world, as
more and more people are becoming infected with microbes that are resistant to a variety of
antimicrobials. Thus, there is an increasing number of deaths due to there not being any effective
antimicrobials to treat the microbial infections. These multi-drug resistant microbes originated
from hospital and agricultural settings. From not understanding what the improper usage of
antimicrobials can cause, more and more microbes become multi-drug resistant. The methods
and systems that have been proposed in this paper offer solutions to decrease the percentage of
antimicrobial resistance and even possibly prevent antimicrobial resistance. By implementing
systems in which antimicrobial usage is limited, as well as educating the general population on
the proper usage of antimicrobials, a world in which antimicrobial resistance is a not a major
public health concern can be attained.
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Works Cited
“Antimicrobial Resistance.” WHO. N.p., n.d. Web. 04 Apr. 2015
“Antibiotic Resistance Solutions Initiative.” Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention, 06 Feb. 2015. Web. 04 Apr. 2015.
"Antibiotic Resistance Threats Report and Foodborne Germs." Centers for Disease Control and
Prevention. Centers for Disease Control and Prevention, 14 Apr. 2014. Web. 06 Apr.
2015.
"CDC: Hospitals Major Source of Antibiotic-resistant Infections." CBSNews. CBS
Interactive, n.d. Web. 06 Apr. 2015.
Spellberg, Brad, Robert Guidos, David Gilbert, John Bradley, Helen Boucher, John Bartlett, and
John Edwards. "Clinical Infectious Diseases." The Epidemic of Antibiotic-Resistant
Infections: A Call to Action for the Medical Community from the Infectious Diseases
Society of America. N.p., n.d. Web. 04 Apr. 2015.
"Sweden Uses the Fewest Antibiotics in Food Production." EurActiv. N.p., n.d. Web. 06 Apr.
2015.