Bacterial antibiotic resistance: medicine’s paramount challenge

Abstract

Antibiotic action against bacteria is based on their ability to bind to certain targets of the bacterial structure, inactivating the target. In spite of this, as the time of generalized antibiotic usage goes by, these drugs lose their efficiency in such a way that they become useless for clinical practice. Bacterial antibiotic resistance is due to both mutations and the acquisition –from other bacteria– of genes encoding certain proteins that make bacteria resistant by different mechanisms. Antibiotic resistance in Mycobacterium tuberculosis is only due to mutations while in Staphylococcus aureus and other taxa it is mainly due to genes acquired from other bacteria. More than 2 million people around the world die every year from antibiotic-unresponsive infections. Resistance has been exacerbated because of the huge amounts of antibiotics used worldwide for several purposes. Physicians should be better informed about resistance in order to reduce antibiotic prescription when such treatment is not necessary. Moreover, doctors should also teach their patients using the information available about adverse effects of antibiotics, including diarrhea, vaginal candidiasis, hepatic affections, and probably cancer. The massive use of substances capable of efficiently diminishing infectious processes started in the 1940’s, beginning the antibiotic era. Even though sulfa drugs had been used to treat infections, the antibiotic efficient against severe infections, as those produced by the fearsome Staphylococcus aureus, was penicillin. This pioneer antibiotic was introduced in the market in 1943 with an effect that seemed magic, because it was efficient in all the infectious processes caused by such biological agent. Nevertheless, just three years later strains resistant to this antibiotic were detected and the selection was so intense that in 1950 40% of strains were resistant and by 1960 the percentage increased to 80%. The aim of this article is to highlight the importance that antibiotic bacterial resistance has acquired in the last decades, its causes, and some strategies that may be followed in order to control it.