to the next generation . An entire new population of bacteria which is immune to the antibiotic is therefore created .
The processes which take place due to the genetic changes responsible for antibiotic resistance are extremely complex ; they are therefore not understood well , and very little progress has been made in trying to find ways to prevent it ( Davies and Davies , 2010 ).
What are ‘ Superbugs ’?
Bacterial Superbugs are bacteria with very high levels of antibiotic resistance , such as MRSA . They can quickly infect patients and spread rapidly as there is little that can be done to stop them ( ScienceNews , 2013 ); this is especially so because an important characteristic of bacterial Superbugs is resistance to several different antibiotics .
Infections caused by Superbugs can be very dangerous , making them the cause of an increasing number of deaths and disabilities throughout the world . Therefore , it is extremely important to control resistance to stop a superbug which is immune to all existing antibiotics from emerging ( NHS , 2019 ).
Superbug bacteria show resistance by the same fundamental processes as other bacteria , but the processes are better adapted for resistance in Superbugs , with some modifications that are advantageous to survival against antibiotics ( Benveniste and Davies , 1973 ; Foster , 2004 ; Chang et al ., 2014 ).
Discussion
Causes of resistance
A major cause of antibiotic resistance has been the overuse of antibiotics . As mentioned previously , the use of an antibiotic on a population of bacteria has the potential to create a new , resistant population of the bacteria . More frequent use of an antibiotic therefore means a greater number of opportunities for a resistant population to be created .
Figure 1 shows the extent of antibiotic use in the
United States in 2017 ; it can be seen that a significant proportion of states are on the higher end of the scale . A few states are at the maximum level , with more than 900 antibiotic prescriptions per 1000 people in one year .
It is concerning that , in the US , at least 30 % of antibiotics that are prescribed in the outpatient setting ( where around 80-90 % of human antibiotic use occurs ) are done so unnecessarily , and that nearly 50 % of antibiotic use in the outpatient setting is inappropriate ( Centers for Disease Control and Prevention , 2019 ).
Another issue is self-medication , which is when someone takes antibiotics without first consulting a certified medical professional . Unless a patient has expert knowledge , it is likely that when patients self-medicate , they do not know exactly what they are doing , and when it is appropriate or not to take antibiotics . Not consulting a medical professional increases the chances of an antibiotic being taken when it is not necessary .
Also , some antibiotics are available over the counter , without the need for a prescription . This encourages people to use these drugs as the fact that they are so easily available gives the impression that professional guidance is not required .
The general public does not fully understand antibiotic resistance and how to use antibiotics properly ; in a recent study involving around 55,000 members of the public , only around 70 % of participants said they had heard about antibiotic resistance in the past . This means that a large number of people do not know about resistance , which means they are not aware of the most significant negative effect of inappropriate antibiotic use ( Bajpai et al ., 2017 ).
Resistance mechanisms
There are several mechanisms by which bacteria can show resistance to antibiotics , such as those shown in figure 2 . The main categories of mechanism are modification of a bacterium ’ s own structure , and modification of the structure of the antibiotic .
A bacterium can modify parts of its structure in a
Article # 2 23