Antibiotics have saved millions of lives but overuse and misuse has led to rising antibiotic resistance where bacteria evolve and become immune to existing drugs. Antibiotic resistance occurs through natural selection that favors resistant bacteria and spreads between bacteria through horizontal gene transfer. It is a growing problem worldwide as some infections are becoming impossible to treat. To slow resistance, we must use antibiotics judiciously and responsibly only when needed, take the full prescribed dose, and develop new drugs.

2. ANTIBIOTICS
• Antibiotics also
called antibacterial , are a type
of antimicrobial drug used in
the treatment and prevention
of bacterial infections.
• They may either kill or inhibit
the growth of bacteria,
preventing from reproducing
and spreading.
• Antibiotics aren't effective
against viral infections, such as
the common cold, flu, coughs
etc

3. IMPORTANCE OF ANTIBIOTICS
• Antibiotics are medicines used to treat a wide
variety of infections or diseases caused by
bacteria, such as respiratory tract infections (eg,
pneumonia and whooping cough), urinary tract
infections, skin infections and infected wounds.
• Antibiotics have saved millions of lives since they
were first introduced in the 1940s and 1950s.
• However, because they have been overused,
many antibiotics are no longer effective against
the bacteria they once killed.

4. ANTIBACTERIAL RESISTANCE
• Also known as drug resistance.
• Antibiotic resistance is the ability of bacteria
to resist the effects of an antibiotic.
• Antibiotic resistance occurs when bacteria
change in a way that reduces the effectiveness
of drugs, chemicals, or other agents designed
to cure or prevent infections.
• The bacteria survive and continue to multiply,
causing more harm.

5. • Antibiotic resistance is a natural phenomenon. When an
antibiotic is used, bacteria that can resist that antibiotic
have a greater chance of survival than those that are
"susceptible." Susceptible bacteria are killed or inhibited by
an antibiotic, resulting in a selective pressure for the
survival of resistant strains of bacteria.
• Antibiotic resistance is rising to dangerously high levels in
all parts of the world. New resistance mechanisms are
emerging and spreading globally, threatening our ability to
treat common infectious diseases. A growing list of
infections such as pneumonia, tuberculosis, blood
poisoning, are becoming harder, and sometimes
impossible, to treat as antibiotics become less effective.

6. HOW???

7. MECHANISM OF ANTIBIOTIC RESISTANCE
NATURAL ACQUIRED
GENETIC
MUTATION
FROM ANOTHER
BACTERIUM
BY CONJUGATION BY TRANSDUCTION
BY
TRANSFORMATION

8. INTRINSIC RESISTANCE
• Some bacteria are naturally resistant to certain
antibiotics. For example, antibiotics inhibiting cell wall
synthesis are useless for Mycoplasma as these
organisms lack cell wall.
• Similarly, most Gram-negative bacteria are resistant to
glycopeptide antibiotics like vancomycin.

9. MUTATIONS
• Different genetic mutations yield different types of
resistance.
• Some mutations enable the bacteria to produce potent
chemicals (enzymes) that inactivate antibiotics
• Other mutations eliminate the cell target that the antibiotic
attacks. Still others close up the entry ports that allow
antibiotics into the cell, and others manufacture pumping
mechanisms that export the antibiotic back outside so it
never reaches its target.

10. FROM OTHER BACTERIA
• By conjugation:
Two cells come in contact, a process called conjugation,
bacteria can transfer genetic material, including genes
encoding resistance to antibiotics from one bacterium to
another by making a connecting tube between two bacteria
and making the new cell antibiotic-resistant as well.

11. • By transduction:
Viruses are another mechanism for passing resistance traits
between bacteria. The resistance traits from one bacterium
are packaged into the head portion of the virus. The virus
then injects the resistance traits into any new bacteria it
attacks. Bacteria also have the ability to acquire naked, "free"
DNA from their environment.

12. • By transformation:
Free DNA is picked up from the environment (i.e.
From a cell belonging to closely related or same
strain).

13. WHY ??

14. • Overuse and Over prescription of
Antibiotics:
In 1945, Sir Alexander Fleming raised the alarm
regarding antibiotic overuse when he warned that
the “public will demand [the drug and] … then will
begin an era … of abuses.”
Epidemiological studies have demonstrated a direct
relationship between antibiotic consumption and
the emergence of resistant bacterial strains.
Every time a person takes antibiotics, sensitive
bacteria are killed, but resistant bacteria are left to
grow and multiply. This is how repeated use of
antibiotics can increase the number of drug-resistant
bacteria.

15. • Not finishing Antibiotic course:
Complete the full course of the drug. It's important
to take all of the medication, even if you are feeling
better. If treatment stops too soon, the drug may
not kill all the bacteria and you may become sick
again, and the remaining bacteria may become
resistant to the antibiotic that you've taken.
• Misuse of Antibiotics:
smart and correct use of antibiotics is key to
controlling the spread of resistance.
Antibiotics are not effective against viral infections
like the common cold, flu, most sore throats,
bronchitis, and many sinus and ear infections.
Widespread use of antibiotics for these illnesses is
an example of how misuse of antibiotics can
promote the spread of antibiotic resistance.

16. In both the developed and developing world, antibiotics are
widely used as growth supplements in treating livestock. It is
said to improve the overall health of the animals, producing
larger yields and a higher-quality product.
The antibiotics used in livestock are ingested by humans
when they consume food. This occurs through the following
sequence of events:
1) antibiotic use in food-producing animals kills or
suppresses susceptible bacteria, allowing antibiotic-resistant
bacteria to thrive
2) resistant bacteria are transmitted to humans through the
food supply
3) these bacteria can cause infections in humans that may
lead to adverse health consequences

17. • Availability of Few New Antibiotics:
The development of new antibiotics by the pharmaceutical industry, a strategy that
had been effective at combating resistant bacteria in the past, had essentially
stalled due to economic and regulatory obstacles as antibiotic development is no
longer considered to be an economically wise investment for the pharmaceutical
industry.
The last new antibiotic class that has been introduced as medicine was discovered
in 1987 . Older antibiotics are rapidly becoming ineffective due to antibiotic
resistance. As some bacteria already resistant to all available antibiotics

18. • Poor hygiene :
Poor hygiene and poor infection prevention and control can provide more
opportunity for resistant bacteria and other germs to spread. Makes more people
sick and increase the need for antibiotics.
Hand hygiene is the most important way of preventing the spread of infections
including antibiotic resistant infections.
• Environmental pollution:
Antibiotics have been polluting the environment since their
introduction through human waste (medication, farming), animals, and
the pharmaceutical industry. Releasing large quantities of antibiotics
into the environment through inadequate wastewater treatment
increases the risk that antibiotic-resistant strains will develop and
spread.

19. HOW DOES ANTIBIOTIC RESISTANCE
SPREAD?

20. • Genetically, antibiotic resistance spreads through
bacteria populations both:
• “vertically” when new generations inherit antibiotic
resistance genes, and
• "horizontally” when bacteria share or exchange
sections of genetic material with other bacteria.
Horizontal gene transfer can even occur between
different bacterial species.
• Environmentally, antibiotic resistance spreads as
bacteria themselves move from place to place; bacteria
can travel via airplane, water and wind. People can pass
the resistant bacteria to others; for example, by
coughing or contact with unwashed hands.

21. CAN BACTERIA LOSE THEIR ANTIBIOTIC RESISTANCE?
Yes, antibiotic resistance traits can be lost, but this reverse
process occurs more slowly. If the selective pressure that is
applied by the presence of an antibiotic is removed, the
bacterial population can potentially revert to a population of
bacteria that responds to antibiotics.

22. PREVENTION AGAINST ANTIBIOTIC
RESISITANCE

23. Preventing the anti-biotic Resistance
• Although resistance is not a new phenomenon, the
incidence has increased dramatically over the past 2
decades. The development of new drugs has slowed
considerably and may be unable to keep pace with the
continuing growth of pathogen resistance.
• Therefore, effective strategies are needed to prevent
the continuing emergence of antimicrobial resistance.
These include the avoidance of unnecessary antibiotic
administration and increasing the effectiveness of
prescribed antibiotics, as well as implementing
improvements in infection control and optimizing
medical practice.

24. Here is what you can do to help prevent
antibiotic resistance:
Tell your healthcare professional you are concerned
about antibiotic resistance.
Ask your healthcare professional if there are steps you
can take to feel better and get symptomatic relief
without using antibiotics.
Take the prescribed antibiotic exactly as your healthcare
professional tells you.
Discard any leftover medication.
Ask your healthcare professional about vaccines
recommended for you and your family to prevent
infections that may require an antibiotic.

25. Never skip doses.
Never take an antibiotic for a viral infection like a
cold or the flu.
Never pressure your healthcare professional to
prescribe an antibiotic. Never save antibiotics
for the next time have you got sick.
Never take antibiotics prescribed for someone
else.

26. Healthcare professional can prevent the
spread of antibiotic resistance by
Prescribing an antibiotic only when it is likely to benefit
the patient.
Prescribing an antibiotic that targets the bacteria that
is most likely causing their patient’s illness when an
antibiotic is likely to provide benefit.
Encouraging patients to use the antibiotic as
instructed.
Collaborating with each other, office staff, and patients
to promote appropriate antibiotic use.
Continue reviewing and following the latest clinical
practice guidelines for common infections, such as
CDC’s Adult and Pediatric Academic Detailing Sheets.

27. THANK YOU