![]() ![]() The use of antibiotic alternatives to promote health and reduce disease will decrease antibiotic use, thereby decreasing selective pressure for the emergence and transmission of antibiotic-resistance genes.Īntibiotics are used for disease treatment and prevention in both humans and animals. ![]() Nonetheless, central to executing antibiotic prudency is the availability of efficacious alternatives to antibiotics. This is a nebulous concept that is difficult to define-particularly in cases of human health when the health of the individual, not the population, is of immediate importance. Antibiotic prudency is also important to decrease the selective pressure for the eventual emergence of as yet unknown antibiotic-resistance genes.Īntibiotic prudency is the use of antibiotics only when they are expressly needed and at the most appropriate dose for disease treatment. One example of this is the emergence of the clinically relevant and plasmid-borne CTX-M-5 extended-spectrum beta-lactamases from the chromosome of the commensal bacterium Kluyvera ascorbata. ![]() Compared to anthropogenically selected resistance genes, these resistance genes are not commonly found on mobile genetic elements (MGEs), and so they face a multistep path of selection onto MGEs-such as integrons, transposons, and plasmids-before they will arrive in a human pathogen. Finally, novel resistance genes that are not yet clinically relevant can emerge from the vast reservoirs of environmental and commensal bacteria due to selective pressure. Therefore, prudent use of antibiotics is one potential mitigation strategy to slow the spread of resistance genes among bacteria. Resistance gene transfer events can be stimulated by antibiotics themselves. Second, highly mobile resistance genes can be horizontally transferred from one bacterium to another. These resistant bacteria spread in the environment via water, air, wildlife, and humans, so targeted mitigation strategies are needed to decrease the environmental dissemination of antibiotic-resistant bacteria from “hot spots” of potential resistance development. First, more than 70 years of antibiotic use have already selected for diverse and highly mobile antibiotic resistance genes in human pathogens and related bacteria. The complex factors that have led to the antibiotic resistance problem are revealed when examining potential solutions to reduce or prevent this problem. Reducing or preventing the dissemination of antibiotic resistance genes into human pathogens is currently of high international importance. As antibiotic resistance continues to evolve, antibiotics of so-called last resort become even more precious. The acquisition of such resistance genes by pathogens complicates disease treatment, increases health care costs, and increases morbidity and mortality in humans and animals. The antibiotic resistance problem is caused by the evolution and transfer of genes that confer resistance to medically important antibiotics into human pathogens. ![]()
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