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Benjamin Booker
English 2089
Professor Dorhout
29 May 2015
Antimicrobial resistance
Antimicrobial resistance is an issue that is similar to the issue of global warming; there is
some debate on whether or not it is actually occurring, but the millions of people that are aware of
its existence do very little to combat the issue. Antimicrobial resistance is the ability of microbes to
grow in the presence of a chemical (drug) that would normally kill them or limit their growth. The
chemical drugs that are referred to in the definition above are drugs such as antibiotics, which target
bacteria; antivirals, which target viruses; antimalarial drugs, which target parasites such as malaria;
and antifungals, which target fungi. The lack of regulation of the distribution of anti-microbial
drugs, specifically antibiotics, and the over prescription of anti-biotic drugs is shocking. Antimicrobial resistance is occurring and the allowed abuse of anti-microbial drugs, especially
antibiotics, is the largest contributing factor. It is imperative that we impose more stringent
regulations on the distribution and the prescription of anti-biotic drugs in order to reduce
antimicrobial resistance.
Anti-microbial resistance, as previously discussed, is the resistance of a microbe (bacteria,
virus, fungus, or parasite) to a drug that would normally harm it. The way that this resistance occurs
is very complex. A good analogy would be to compare it to that of the human immune system: a
human being receives a vaccination, which is a small dose of a specific virus or bacteria, and the
immune system of the individual who was vaccinated fights off the small amount of the pathogen
and produces anti-bodies that will respond more readily to an infection by the same pathogen when
exposed again. The same is true of a bacteria or virus, if the microbe was exposed to an
antimicrobial and it does not destroy it, but destroys the other microbes around it, the living
microbe will fight off the drug and build up an immunity and have more room to grow and

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replicate. That resistance will be incorporated into its genetic makeup and be replicated more
rapidly and passed onto its offspring. Nearly every pathogen has this ability to build up a resistance
to our drugs and many of these pathogens are becoming increasing more difficult to combat.
The World Health organization (WHO) reported, In 2013, there were about 480,000 new
cases of multi-drug resistant tuberculosis (MDR-TB) and extensively drug resistant tuberculosis
(XDR-TB) has been identified in 100 countries. The WHO also stated that treatment failures to
resistance to treatments of last resort for gonorrhea (third-generation cephalosporins) have been
reported from 10 countries. Gonorrhea may soon become untreatable as no vaccines or new drugs
are in development (The World Health Organization). Along with MDR-TB, XDR-TB, and
gonorrhea, there are thousands of other microbes that are becoming increasingly resistant, such as
the more known pathogens like Methicillin resistant Staph aureus (MRSA), increasing resistant
strains of HIV, Urinary tract infection resistant bacteria like E. coli, resistant forms of malaria,
influenza A (the flu) viruses and many more. The largest contributor to this resistance is the faulty
prescription of anti-biotic drugs.
The misuse of anti-biotic drugs is obvious when we examine our data. The Center for
Disease control (CDC) reported that approximately 258 million courses of antibiotics were
prescribed to a United States population of 309 million people. That comes out to 4/5 Americans
being prescribed an anti-biotic. The CDC also reported that the most frequent prescription of antibiotic was for a bronchitis diagnosis (The Center for Disease Control). According to the Family
Physicians of Canada viruses cause about 85-95% of bronchitis. The CDC and the WHO found
similar results (Worrall/Center for Disease Control/World Health Organization). Antibiotics are not
effective in treating viral infections and this abuse is only contributing to the vaccination of the
thousands of organisms already in your system. According to Graham Worrall, a professor of
Family Medicine at the Memorial University of Newfoundland, the vast majority of patients who
are diagnosed with acute bronchitis dont need treatment. Dr. Worrall states that results from the

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control groups of trials show that 85% of patients will improve without specific treatment. The
consensus seems to be that antibiotics have a modest benefit for only a minority of patients and are
not needed to treat most patients with acute bronchitis (Worrall).
Not only are physicians wrongly prescribing antibiotics for bronchitis diagnosis in adults
but they are mis-prescribing antibiotics to children for acute otitis media (common ear infection,
AOM). A survey published by Boston University found that 85 percent of the time, when ear
infections were minor, doctors ignored guidelines and prescribed antibiotic drugs (Moyer).
However, there is no evidence to suggest that antibiotics are effective in the treatment for ear
infections. In fact a study published by the National Center for Biotechnology Information
concluded We found that antibiotics were not very useful for most children with AOM; antibiotics
did not decrease the number of children with pain at 24 hours (when most children were better
anyway) (National Center for Biotechnology Information). Mayo Clinic indicates that
symptoms of ear infections usually improve within the first couple of days, and most infections
clear up on their own within one to two weeks without any treatment (The Mayo Clinic Staff).
Therefore, there is no need for an antibiotics prescription.
However it is not only physicians that are at fault for the abuse of antibiotics but online
vendors. A paper published by researchers from the department of family medicine at the
University of South Carolina concluded that over 138 vendors on the internet were selling
antibiotics without prescription including penicillins and cephalosporins (Mainouss). The worst part
is that it is not illegal.
Antimicrobial resistance is a serious issue that is plaguing our society today due to the over
prescription and misuse of antibiotics. Organisms that we were once able to treat are becoming
more and more difficult to destroy. There needs to be a change. It is imperative that laws and strict
regulations of the prescription and distribution of antibiotics are enacted.

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Works Cited

Center for Disease Control. CDC: 4 Out of 5 Americans prescribed antibiotics each year.
http://www.cbsnews.com/news/cdc-4-out-of-5-americans-prescribed-antibotics-each-year. 11 April
2013. Web. 26 May 2015.
Mainouss, Arch G., III, PhD, Charles J. Everett, PhD; Robert E.Post, MD; Vanessa A. Diaz,
MD, MS, and William J. Hueston, MD. Availability of Antibiotics for Purchase without a
Prescription on the Internet. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746509. 20 January
2009. Web. 26 May 2015.
Mayo Clinic Staff. Ear Infection (Middle Ear).
www.mayoclinic.org/diseases-conditions/ear-infections/basics/treatment/con-20014260. 20 Apr.
2013. Web. 31 May 2015.
Moyer, Melinda Wenner. That Is Not an Ear Infection.
www.slate.com/articles/double_x/the_kids/2013/01/ear_infections_why_are_doctors_so
_quick_to_prescribe_antibiotics_for_toddler.html. 3 Jan. 2015. Web. 31 May 2015.
National Center for Biotechnology Information. Antibiotics for Middle-ear Infection (Acute
Otitis Media) In Children. www.ncbi.nlm.nih.gov/pubmedhealth/PMH0010556. 8 Nov. 2012.
Web. 31 May 2015.
World Health Organization. Antimicrobial Resistance.
http://www.who.int/mediacentre/factsheets/fs194/en. April 2015. Web. 26 May 2015.
Worrall, Graham, MBBS, MSc, MRCGP, FCFP. Acute Bronchitis.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2278319. February 2008. Web. 26 May 2015.

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