Gude Sai Sreeya, Venu Gopal Shravya, Marasandra Ramesh Harshita, Vuppalapati Sravya, Peddi Nikhil Chowdary, Gude Sai Sravya
Internal Medicine, Guntur Medical College, Guntur, IND.
Internal Medicine, Kasturba Medical College, Mangalore, Mangalore, IND.
Cureus. 2022 Apr 8;14(4):e23955. doi: 10.7759/cureus.23955. eCollection 2022 Apr.
Antimicrobial resistance is an increasing problem worldwide that has been exacerbated by antibiotic misuse worldwide. Growing antibiotic resistance can be attributed to as well as leads to severe infections, complications, prolonged hospital admissions, and higher mortality. One of the most important goals of administering antimicrobials is to avoid establishing antibiotic resistance during therapy. This can be done by drastically lowering worldwide antimicrobial usage, both in present and future. While current management methods to legislate antimicrobials and educate the healthcare community on the challenges are beneficial, they do not solve the problem of attaining an overall reduction in antimicrobial usage in humans. Application of rapid microbiological diagnostics for identification and antimicrobial susceptibility testing, use of inflammation markers to guide initiation and duration of therapies, reduction of standard antibiotic course durations, individualization of antibiotic treatments, and dosing considering pharmacokinetics are all possible strategies to optimize antibiotic use in everyday clinical practice and reduce the risk of inducing bacterial resistance. Furthermore, to remove any impediments to proper prescribing, strategies to improve antibiotic prescribing and antibiotic stewardship programs should enable clinical reasoning and enhance the prescribing environment. In addition, the well-established association between antimicrobial usage and resistance should motivate efforts to develop antimicrobial treatment regimens that facilitate the evolution of resistance. This review discusses the role of antibiotics, their current application in human medicine, and how the resistance has evolved to the existing antibiotics based on the existing literature.
抗菌药物耐药性是一个在全球范围内日益严重的问题，全球抗生素的滥用使其进一步恶化。抗生素耐药性的不断增加既可能导致严重感染、并发症、住院时间延长和死亡率上升，同时也是由这些因素引起的。使用抗菌药物的最重要目标之一是在治疗期间避免产生抗生素耐药性。这可以通过大幅降低目前及未来全球范围内抗菌药物的使用量来实现。虽然目前规范抗菌药物使用并就相关挑战对医疗界进行教育的管理方法是有益的，但它们并不能解决实现人类抗菌药物使用总量减少这一问题。应用快速微生物诊断技术进行鉴定和抗菌药物敏感性测试、使用炎症标志物来指导治疗的开始和持续时间、缩短标准抗生素疗程、实现抗生素治疗个体化以及根据药代动力学进行给药，都是在日常临床实践中优化抗生素使用并降低诱导细菌耐药性风险的可行策略。此外，为消除合理处方的任何障碍，改善抗生素处方的策略和抗生素管理计划应有助于临床推理并改善处方环境。此外，抗菌药物使用与耐药性之间已确立的关联应促使人们努力开发有助于减少耐药性产生的抗菌治疗方案。本综述基于现有文献讨论了抗生素的作用、它们目前在人类医学中的应用以及耐药性是如何演变成对现有抗生素的耐药性的。
