ANTIMICROBIAL RESISTANCE: REVIEW

Antimicrobial resistance (AMR) is resistance of a microorganism to an antimicrobial that was originally effective for treatment of infections caused by it. Increasing clinical incidence of antimicrobial resistance is a major global health care issue and the situation is perhaps aggravated in developing countries. Although, AMR is a major health care issue, there is a shortage of documented information on it. Therefore, the aim of this paper is to review the causes or risk factors, problems, mechanisms and control of antimicrobial resistance. The resistance problem can be seen simplistically as an equation with two main components: the antibiotic or antimicrobial drug, which inhibits susceptible organisms and selects the resistant ones; and the genetic resistance determinant in microorganisms selected by the antimicrobial drug. Antimicrobial resistance is associated with high mortality rates and high medical costs and has a significant impact on the effectiveness of antimicrobial agents. To appreciate the mechanisms of antimicrobial resistance, it is important to understand how antimicrobial agents act. The resistance mechanisms therefore depend on which specific pathways are inhibited by the drugs and the alternative ways available for those pathways that the organisms can modify to get a way around in order to survive. A comprehensive strategy is necessary to address the challenges that accompany the rising threat of antimicrobial resistance. Special vigilance must now be paid to appropriate selection and timing of antimicrobial agents as a major force in reducing the development of antimicrobial resistance. Prevention and control of these infections will require new antimicrobial agents, prudent use of existing agents, new vaccines, and enhanced public health efforts to reduce transmission.