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What You Need to Know About Antimicrobial Resistance

Medically Reviewed by Dan Brennan, MD on November 21, 2022

If you’ve ever had food poisoning, the flu (influenza), or strep throat, chances are your doctor gave you antimicrobial medications to get rid of the infection in a few days. "Antimicrobial drug" is a term used for drugs that are designed to fight off and kill disease-causing microbes (germs) like bacteria, viruses, parasites, and fungi.

But over time, some of these germs become “resistant” to antimicrobial drugs. This means some medications can no longer clear the infection and work as they’re supposed to. This is called antimicrobial resistance, and it’s a growing concern.

In fact, resistant germs affect over 2 million people in the U.S. each year and kill more than 20,000 people. The World Health Organization (WHO) has declared antimicrobial resistance as one of the top 10 threats to human health.

Here’s a look at why you should care.

What Does Antimicrobial Resistance Mean?

In the early 1900s, scientists began to develop antimicrobial drugs to kill germs that cause conditions like pneumonia, colds, urinary tract infections, food poisoning, and the flu.

There are many types of antimicrobial drugs. For example, fluconazole is a type of antifungal drug. It helps to get rid of fungi growth in your body. And penicillin is a type of antibiotic that was designed to fight certain bacterial infections.

But over time, a small number of germs are able to adapt, evolve, and “resist” or defeat the specific drugs designed to kill them and continue to live in your body. This is usually because of genetic changes. Over time, those particular drugs no longer work, and this strain of resistant germ is able to multiply and spread. You or those affected by this germ or bacteria could get seriously ill. For example, if you have pneumonia that’s penicillin-resistant, it means penicillin won’t get rid of the infection. You’ll have to try other antibacterial treatments that the bacteria isn’t resistant to. But if you get infected by a germ or bacteria that’s not resistant to penicillin, you could still use penicillin. Only the germ becomes resistant to specific drugs not your body.

Some germs are able to resist many types of antimicrobial drugs. These are called “superbugs.” And they’re usually very difficult to treat.

How Do Resistant Germs Work Against Antimicrobial Medications?

When a germ builds resistance toward a drug, it:

  • Reduces your body’s ability to absorb the medication
  • Re-routes the drug’s target away from itself
  • Mutes the medication’s effects
  • Removes the medication from your bloodstream, cells, or other targeted parts of the body

What Causes Antimicrobial Resistance?

There are many things that can increase the odds of a germ becoming resistant to drugs, such as:

Health care workers overprescribing antimicrobial drugs. In some cases, doctors and other health care providers might give you antimicrobial drugs for conditions that may not need them. For example, if you have a viral cold, antibiotics won’t work for you. That’s because they're designed to fight a different type of microbe.

They might also ask you to take the drugs at a higher dose or for a longer time than necessary. While these are live-saving drugs, over-exposure to them could allow the germs to build “resistance mechanisms.” This means they’ll adapt to find loopholes or strategies to fight back against the drug. This makes the germ harder to treat.

Use of broad-spectrum drugs. Sometimes, doctors prescribe drugs that are designed to target many types of germs instead of one.

Working in health care settings. Close contact with drug-resistant microbes increases your odds of being infected with them. This makes them harder to treat.

Antibiotic use in agriculture. Pesticides used to limit bacteria or viral growth in plants or animals can also lead to antimicrobial resistance. This might pass on to you through what you eat and drink.

How Is Antimicrobial Resistance Different from Antibiotic Resistance?

Antimicrobial resistance refers to all microbes, like bacteria, viruses, fungi, and parasites, that resist drugs. Antibiotic resistance is a term used to refer only to bacteria that resist treatment.

Who Does Antimicrobial Resistance Affect?

It can affect everybody of any age.Resistant microbes can be found everywhere: humans, food, plants, soil, and air. They're contagious, and you can come in contact with them in many ways.

You’re more likely to be affected by antimicrobial-resistant germs if you have a weak immune system or if you get sick often.

How Is Antimicrobial Resistance Diagnosed?

If you have a bacterial or viral infection, there are a few tests, like blood samples or swabs, your doctor can run to check if you’ve been infected by a drug-resistant strain of germ.

For example, an antibiotic sensitivity test (AST) can be done in a lab to check if the bacteria that are present are resistant to certain drugs. If that’s the case, your doctor will give you a medication that’s more likely to kill the bacteria. This test can be used for fungal infections, too.

But lab tests to diagnose antimicrobial resistance could take a few days or weeks to come back. This can delay treatment.

Can you Treat Antimicrobial Resistance?

If you don’t respond well to medication because of possible resistance, your doctor will try more aggressive or alternative treatment options.

They may:

  • Give you a higher dose of the antimicrobial drug
  • Have you take the drug for a longer period of time
  • Add other drugs to the treatment
  • Try a different medication
  • Try non-medication options to fight resistant bacteria

Can You Prevent Antimicrobial Resistance?

Germs will naturally always try to change and adapt to get around antimicrobial drugs. But you can take some steps to prevent or lower your odds of infection from antimicrobial-resistant germs.

You can:

  • Check with your doctor before you start on new medications. Be sure it’s the correct medication to fight the specific infection or condition.
  • If your doctor prescribes a course of medication, follow the directions closely. Don’t skip or double up on your doses. Check with your doctor before you do.
  • Don’t save prescription drugs for later use. Get rid of them after use.
  • Keep your cuts or wounds clean and covered till they heal.
  • Wash your hands often. This will lower your odds of coming in contact with resistant germs.
  • Get vaccinations as your doctor recommends.
  • Use protection to prevent sexually transmitted infections.
  • Be cautious when you travel abroad. Practice food and drink safety to prevent food poisoning and other infections.

Show Sources

SOURCES:

CDC: “Antimicrobial Resistance.”

World Health Organization: “Antimicrobial Resistance.”

Cleveland Clinic: “Antimicrobial Resistance.”

Healthychildren.org: “The History of Antibiotics.”

Medline.gov: “Antibiotic Sensitivity Test.”

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