General antibacterial resistance: causes, hazards and prevention

In the area of general medicine, antibacterial drugs are widely used, but the associated antibacterial drug resistance problem is also becoming more acute and poses a significant threat to public health security. An in-depth understanding of its causes, its hazards and the search for effective means of prevention are crucial to ensuring the health of the population.I. Causes of anti-bacterial resistance(i) Overuse and abuseOveruse of anti-bacterial drugs is more common in general consultations. On the one hand, some doctors, due to lack of clinical experience or to the patient ‘ s acute need for treatment, pre-pregnant prescriptions for antibacterial drugs are introduced without a precise determination of the type of infection. For example, some viral respiratory infections, such as common flu and influenza, do not require antibacterial treatment, but many patients are still given antibiotics. On the other hand, it is common for patients to use their own medication. Many people buy antibacterial drugs on their own on the basis of past experience or advice from others when there are minor symptoms such as cough, throat pain, etc., which may be caused by viruses or other non-bacteriological factors. This irrational use of drugs perpetuates bacteria under pressure from antibacterial drugs and provides a hotbed for the creation of resistance.(ii) Irregular drug treatmentMany patients do not follow the science-based drug treatment procedure when using anti-bacterial drugs. Some patients stop using their own drugs after a slight improvement in their symptoms, at which point the bacteria in their body may not have been completely eliminated and the remaining bacteria are susceptible to variability and gradual resistance in the low-intensity antibacterial drug environment. On the contrary, there are some patients who, after a period of time, have not seen any tangible effect, rather than re-diagnosing the treatment programme in a timely manner, extending the time of the drug or increasing the dose on their own, which not only increases the risk of bacterial resistance, but may also cause adverse drug effects and further damage to the body.(iii) Broad application in livestock and agricultureIn animal husbandry, in order to prevent animal diseases and promote growth, a large number of antibacterial drugs are added to feed or used directly for animal treatment. The resistant bacteria in these animals can be transmitted to humans through the food chain. For example, the long-term consumption of meat products containing drug-resistant bacteria, the microbial community within the human intestinal tract may be affected and the potential for intestinal planting and transmission of drug-resistant bacteria increases. In agriculture, the use of antibacterial drugs for crop pest control has also led to an increase in the number of resistant bacteria in the environment, and the spread of resistant genes in environmental media, such as soil, water bodies, has further complicated the problem of drug resistance.(iv) Cross-infection and drug resistance transmission in medical settingsHealth hazards in the medical environment of general medical institutions also contribute to the spread of antibacterial drug resistance. For example, incomplete sterilization of medical devices, poor hygiene of wards and poor hygiene of health-care personnel can lead to cross-fertilization of drug-resistant bacteria among patients. In particular, in some primary health-care institutions, limited resources, the risk of relatively weak infection control measures and increased vulnerability to concentrated infections of drug-resistant bacteria have led to widespread dissemination of drug-resistant bacteria at the community level, increasing the risk of their infection.II. Hazards of antibacterial resistance(i) Treatment of hardship and waste of medical resourcesAs antibacterial resistance increases, the otherwise effective antibacterial treatment programmes gradually fail. For general practitioners, this means that fewer and fewer effective drugs are available when confronted with common infectious diseases. Some diseases that could have been easily cured in the past, such as pneumonia, urology infection, skin soft tissue infection, may now require the use of higher-level, more expensive antibacterial drugs and even a combination of drugs for treatment, which not only increases the patient ‘ s medical costs, but also increases the time spent on treatment and consumes more medical resources. In some cases, the lack of effective anti-bacterial drugs may prevent timely control of patients ‘ condition, leading to longer hospitalization periods and increased complications, which seriously affect the quality of life of patients and their prognosis.(ii) Transmission of infection and community prevalenceDrug-resistant infections are spreading more rapidly in the community, and if there are cases of drug-resistant infections and control measures are not in place, they can easily trigger small-scale epidemics in the community. For example, skin soft tissue infections caused by methoxysilin-resistant fungus (MRSA) can spread rapidly in community settings such as homes, schools and nursing homes, especially among vulnerable populations such as the elderly, children, and those with low immunization capacity, can lead to severe infections and even death. In addition, the spread of drug-resistant bacterial infections increases the control stress of the public health system, requiring additional human and material resources for monitoring, isolation and treatment, posing a serious threat to the health and safety of entire communities.(iii) Increased global health crisisThe problem of resistance to antibacterial drugs has crossed national borders and has become a global health crisis. In today ‘ s globalized world, people are moving frequently, and drug-resistant bacteria can spread as travellers spread between countries and regions, leading to a global spread of drug-resistant problems. This affects not only the health-care systems of developed countries, but also developing countries with relatively scarce health resources. A number of diseases that could have been controlled by simple antibacterial treatments, with the potential to trigger large-scale outbreaks of disease, have a significant impact on global public health security systems and impede the achievement of global health goals.III. Prevention of drug resistance(i) Enhanced education and trainingContinuous medical education and professional training are essential for general practitioners. Through regular organization of training courses, academic lectures and case discussions on the rational use of antibacterial drugs, the level of clinical diagnosis and the stock of knowledge of antibacterial drugs by general practitioners is increased to enable them to determine accurately the type of infection, to make a reasonable choice of antibacterial drugs and to follow the standard course of drug treatment. At the same time, the health education of patients should be strengthened, through community awareness campaigns, health talks and the distribution of information materials, so as to increase their knowledge of the correct use of anti-bacterial drugs, inform them of the dangers of their abuse and increase their self-health awareness and drug dependence.(ii) Regulating the use and management of antibacterial drugsIn general medical institutions, a sound anti-bacterial regime should be established. Establish clear guidelines and prescriptions for the use of antibacterial drugs, strictly limit the signs of their use and eliminate unnecessary prescriptions of antibacterial drugs. For example, for viral infections, there is a strong commitment not to use antibacterials; for mild bacterial infections, priority is given to narrow-spectral antibacterials, and the use is adjusted in a timely manner based on pathogen culture and drug sensitivity tests. At the same time, the examination and monitoring of prescriptions for anti-bacterial drugs are being strengthened, the prescriptions of doctors are regularly evaluated, the use of anti-bacterial drugs is being corrected in a timely manner and penalties are being imposed to ensure the rational use of antibacterial drugs.(iii) Improved medical environment and infection controlStrengthening of the health-care environment and infection control at general medical institutions. To ensure strict sterilization and sterilization of medical equipment, to carry out cleaning and disinfection of facilities such as wards, clinics, etc. in accordance with the regulations, and to improve the hand-to-hand compliance of health-care personnel, such as the strict hand-washing or use of hand-sterilizers before and after contact with patients, before and after medical operations. These measures effectively reduce the transmission and cross-infection of drug-resistant bacteria in the medical environment and reduce the risk of drug-resistant bacteria infection in the course of medical treatment for the community.(iv) Promoting cross-cutting cooperation and policy supportAddressing anti-bacterial drug resistance requires cross-cutting cooperation and policy support. In the area of agriculture and livestock, the Government should strengthen its regulation, introduce strict regulations, limit the use of antibacterial drugs in animal and crop cultivation, promote green farming and agricultural production techniques, and reduce the presence of antibacterial drugs in the environment. In the medical field, Governments should increase their investment in the development of anti-bacterial drugs, encourage pharmaceutical enterprises to develop new antibacterial drugs, and strengthen the development of a network of antibacterial surveillance, keeping abreast of the prevalence and distribution of drug-resistant bacteria and providing a basis for the development of scientifically sound anti-bacterial strategies. In addition, international cooperation and communication should be strengthened to address the global challenge of drug resistance to antibiotics.The problem of general antibacterial resistance is a complex and serious public health problem requiring the common attention and efforts of society as a whole. Through an in-depth understanding of its causes and hazards, and through active and effective prevention measures, we are expected to contribute to a certain extent to curbing the spread of antibacterial drug resistance and to contribute positively to the health of the population and global public health security.