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Pocket of Resistance: Societal Causes of Antibiotic Resistance

Amanda Stevenson-Grund - Friday, May 06, 2016

It is estimated that over half of antibiotics prescribed for patients who visit a clinic in the United States are inappropriate. These patients are most commonly seeking care for acute respiratory infections that are caused by viruses.
Centers for Disease Control and Prevention. Get Smart: Know When Antibiotics Work. 2015

Antibiotics, when used properly, kill bacteria.

“What doesn’t kill you makes you stronger.” This certainly does not always apply to human patients, but it does apply to bacteria. Antibiotics are supposed to kill bacteria, but if even one bacterium that has been exposed to antibiotics survives, it can evolve and multiply into a multitude of antibiotic-resistant “superbugs.” Societal causes of antibiotic resistance include over-prescription of antibiotics, patient noncompliance and exposure to other antimicrobial agents.

In some parts of the world, antibiotic resistance spreads because antibiotics are readily available, such as over the counter or via street vendors. In the United States, however, a patient must receive a prescription from a physician to legally purchase antibiotics. Such prescriptions occur too frequently. In some cases, physicians don’t want to see their patients suffer and prescribe them antibiotics on the chance they might do some good. In other cases, patients pressure their doctors into writing the prescription. Sometimes inconclusive tests or symptoms lead to a misdiagnosis. In all of these instances, the unnecessary prescription of antibiotics leads to no benefit for the patient and exposes the body to potential antibiotic resistance.

Patient noncompliance can also lead to antibiotic resistance. Physicians, pharmacists and medication package inserts all warn to use the antibiotics as directed. Some patients stop taking the medication when they start feeling better. This can do great harm in the long run because the bacteria and the antibiotics were introduced, but the antibiotics did not have time to kill all of the bacteria. The exposed but not killed bacteria are more likely to grow into the antibiotic-resistant superbugs.

Oral or injected antibiotics are not the only agents that can cause antibiotic resistance. Antimicrobial detergents, cleaning solutions and face wash are all examples of products that can do just that. Bacteria are exposed to these products and can develop a resistance. A 2002 article in the Journal of Antimicrobial Chemotherapy reports a correlation between such antimicrobial products and community MRSA.

Over-prescription of antibiotics, patient noncompliance and exposure to other antimicrobial agents are all examples of societal causes of antibiotic resistance. Orbis Biosciences’TM technology platform enables the manufacture of format flexible drugs for improved compliance. Such drugs could help alter the trend of antibiotic resistance by reducing opportunities for bacteria to grow stronger.
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