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Overuse of antibiotics increase the risk of developing drug resistance | Research

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Therapy with antibacterial drugs should be stopped as soon as the goals are achieved, otherwise the risk is unreasonably high that the patient will exceed the threshold point beyond which antibiotics simply lose their effectiveness. Such conclusions are led by another study/research of this problem, undertaken by a team of scientists under the general supervision of Professor Robert Birdmore from the University of Exeter.

In the laboratory, we studied the response of different microbiomes—groups of microorganisms that share a common living space in a macroorganism—to different antibiotic regimens that involve limited or increased dosages.

It was found that changes in the duration and dosage of antibiotics, as well as fluctuations in sugar concentration (which mimicked the variability in blood glucose levels in real patients) can, under certain conditions, drive the microbiome through a “point of no return”, i.e. create an irreversible shift towards drug resistance. The scientists say their findings show a mechanism for how the resistance population in the body increases even after antibiotics are discontinued, if the “tipping point” was inadvertently and inadvertently exceeded during treatment.

The new research report was published on Monday, July 9, 2018 in one of the leading specialist journals: Nature Ecology & Evolution.

Professor Birdmore, an expert in mathematical biosciences from the University of Exeter, states:

“Yes, it seems natural to assume that with the withdrawal of the antibiotic in the bacterial strain, resistance to it will also disappear, but we set out to study whether all antibiotics behave in this way. As a result, it turned out that in some clinical situations, the resistance that has already formed does not disappear with the withdrawal of the antibiotic.”

Resistance to antibiotics is formed when a bacterial culture develops the ability to overcome the effect of a drug specifically designed to destroy this culture, and continues to multiply unhindered and actively. However, antibiotic therapy remains the most effective treatment for a wide range of bacterial (microbial) infections, including streptococcal strep throat and pneumonia.

For decades, patients have been strongly advised to complete their courses of antibiotics because it seemed wise to take an extra couple of pills precisely to avoid bacterial mutation and development of drug resistance. However, a new study suggests just the opposite: the more the bacterial microbiome is exposed to antibiotics, the more likely it is that resistance will develop.

A special small study was undertaken in order to trace the influence of the duration of the course of antibiotics on the formation of resistance to them, given the fact that this course is recommended to be prescribed equally to everyone, regardless of individual differences (in particular, in blood sugar levels). During the experiments, the researchers tracked how the fungal co-infection of Candida albicans and Candida glabrata reacted to different doses of an antimicrobial drug, as if taken by a “patient” on sugar.

Both of these fungal cultures are usually found in healthy people, however, being an opportunistic pathogen, i.e. possessing the ability to cause an infectious-inflammatory process under favorable conditions for themselves.

The study showed how the population is immediately reduced with the addition of an antibiotic, but re-blooms soon after the withdrawal.

Critically important is the relationship with the concentration of sugar: if the glucose level in the populations fell, the microbiome more easily reached the “tipping point”, after which stable resistance to the drug is formed.

Meanwhile, the problem of antibiotic insensitivity (resistance) in bacterial pathogens is still acute, and the new study opens up opportunities for further study of the question of when is the best time to stop taking antibiotics in order to prevent the formation of drug resistance.

One of the co-authors, Professor Ivana Gudel adds: “Our body is home to many microbial populations, but we still have to study them one by one in the laboratory, as we expect to get answers to our questions about drug resistance. We have shown that many ideas can be misleading, as the microbiome enters into a much more complex relationship with antibiotics than previously thought; existing insensitivity theories have so far ignored this. Well, then, here is our first surprise: it turns out that even the level of sugar concentration can affect the reaction to the drug!

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