Author：Godfrey S. Bbosa
Why are common bacterial infections that were sensitive to antibiotics/antibacterial agents during the antibiotic golden age have developed resistance in the post-antibiotic golden age and hence causing global public health challenge?
Golden antibiotic age (1940s -1990s) is a period in which all the entire antibiotics/antibacterial agents spectra used in clinical practice were discovered and during this period almost all the bacterial diseases were treatable effectively. These diseases at that time were considered as diseases of the past which is not the same currently in the post–golden antibiotic age. The global medical world is currently experiencing a massive emergence of bacterial resistance to almost all the commonest bacterial infections including the multi-drug resistant tuberculosis (MDR-TB) and the extremely resistant tuberculosis (XDR-TB). Bacterial resistance is where some or sub-populations of bacterial species are able to survive after being exposed to one or more antibiotics/antibacterial agents. The contributing factors to this continued global emergence of bacterial resistance is mainly poor regulation on the use of antibiotics/antibacterial agents especially in developing countries, use of these drugs in non-clinical situations like as growth promoters in animals, maximization of ethanol production in breweries, tissue cultures and many others. Also self-medication of these drugs, inadequate training of healthcare professionals, irrational antibiotics/antibacterial drug prescriptions including polypharmacy is a challenge. The bacterial resistance problem is further exacerbated by the continued and increased promotion of these drugs by Pharmaceutical companies and medical representatives to maximize profit and in this case some of the older effective drugs are abandoned on the expense of the promoted non-effective ones hence increasing the cost and expense of treatments. These continued practices continuously destroy the susceptible bacterial organisms and promotes the growth of the resistant pathogenic organisms. The practices also contribute to global antibiotic pollution where even useful bacteria in the environment that are responsible for the recycling of organic matter are destroyed and thus affecting the microbiota. The lack of investment in development of new and effective antibiotics/antibacterial agents to curb the increased global bacterial resistance by the pharmaceutical companies is a challenge. And therefore emerging global bacterial resistance to the available drugs have led to a devastating consequences including high cost of treatment of common bacterial diseases, prolonged hospitalization, increased incidences of toxicities since in most cases the patients are put on second or third-line drugs that are more toxic like for tuberculosis, wastage of scarce resources by various governments and in some cases deaths as well as social and psychological problems to the victims and their families. Therefore there is an urgent need to address this global health challenge of the increased emerging global bacterial resistance by involving all the stakeholders including regulatory authorities, policy makers, pharmaceutical companies, healthcare professionals and the general public so that intervention measures on use of these drugs can be put in place against these global life threatening superbugs.
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