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Lecture 7

Lecture 7. Antimicrobial Chemotherapy Antimicrobial Resistance Dr.: Abeer El-Sherbiny. Antimicrobial Resistance. Relative or complete lack of effect of antimicrobial against a previously susceptible microbe Mechanisms of Antibiotic Resistance Enzymatic destruction of drug

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Lecture 7

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  1. Lecture 7 Antimicrobial Chemotherapy Antimicrobial Resistance Dr.: Abeer El-Sherbiny

  2. Antimicrobial Resistance • Relative or complete lack of effect of antimicrobial against a previously susceptible microbe Mechanisms of Antibiotic Resistance • Enzymatic destruction of drug • Prevention of penetration of drug • Alteration of drug's target site • Rapid ejection of the drug

  3. How do bacteria become resistant? • Spontaneous Mutation: happen as cells replicate • Gene Transfer: Usually spread through transfer of R plasmid

  4. Antibiotic Selection for Resistant Bacteria

  5. What Factors Promote Antimicrobial Resistance? • Exposure to sub-optimal levels of antimicrobial • Exposure to microbes carrying resistance genes

  6. Slowing the emergence and spread of antimicrobial resistance • Responsibilities of Physicians: must work to identify microbe and prescribe suitable antimicrobials • Responsibilities of Patients:need to carefully follow instructions 3. Educate Public: must understand appropriateness and limitations of antibiotics 4. Global Impacts: organism that is resistant can quickly travel to another country - in some countries antibiotics available on non-prescription basis

  7. Antibiotics in Foods • Antibiotics are used in animal feeds and sprayed on plants to prevent infection and promote growth • Multi drug-resistant Salmonella typhi has been found in 4 states in 18 people who ate beef fed antibiotics

  8. Inappropriate Antimicrobial Use • Prescription not taken correctly • Antibiotics for viral infections • Antibiotics taken without medical supervision • Spread of resistant microbes in hospitals due to lack of hygiene • Lack of quality control in manufacture or outdated antimicrobial • Inadequate surveillance or defective susceptibility assays

  9. Consequences of Antimicrobial Resistance • Infections resistant to available antibiotics • Increased cost of treatment MRSA “mer-sah”(S. aureus) • Methicillin-Resistant Staphylococcus aureus • Most frequent hospital-acquired pathogen • Usually resistant to several antibiotics as beta-lactam agents.

  10. Proposals to Combat Antimicrobial Resistance • Speed development of new antibiotics • Track resistance data nationwide • Restrict antimicrobial use • Direct observed dosing • Use more narrow spectrum antibiotics • Use antimicrobial cocktails

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