Amoxicillin directions

Antimicrobial resistance in the environment: The Indian scenario.

[http://dx.doi.org/10.4103/ijmr.IJMR_331_18] [PMID: 31219076] ]. COMMON MECHANISM TO DEVELOP RESISTANCE IN MICROORGANISM.

The key mechanisms of antimicrobial resistance include enzymatic degradation of antimicrobial produced by bacterial cells, a mutation in the antimicrobial targeting agents and prohibition of antibiotic entry inside the bacterial cells via membrane (Fig.

The spread of antibiotic resistance occurs through genetic material (plasmid or the bacterial chromosome) [ 28 Naguib MM, El-Gendy AO, Khairalla AS. Microbial diversity of mer operon genes and their potential rules in mercury bioremediation and resistance.

Open Biotechnol J 2018; 12(1) [http://dx.doi.org/10.2174/1874070701812010056] , 29 Pitton JS. Mechanisms of bacterial resistance to antibiotics.Ergebnisse der Physiologie Reviews of Physiology 1972; Vol.

World Health Organization, European Centre for Disease Control and World Health Assembly highlighted the antimicrobial resistance as a major public health issue and will be a big challenge to grip for health care workers [ 30 Richardson E. The Role of Public Health Organizations in Addressing Public Health Problems in Europe: The Case of Obesity Alcohol and Antimicrobial Resistance 2018; 51 ].

An establishment of multi-resistant strains arises due to the production of a broad spectrum of ?-lactamases using various bacterial spp. after continuous consumption and became very common [ 31 van Duin D, Paterson DL.

Multidrug-resistant bacteria in the community: trends and lessons learned.

[http://dx.doi.org/10.1016/j.idc.2016.02.004] [PMID: 27208764] ]. Antimicrobial resistance is an important public health concern at the global level. However, in India, recent hospital and community based reports showed an incensement of microbial resistance [ 32 Kumar SG, Adithan C, Harish BN, Sujatha S, Roy G, Malini A.

[http://dx.doi.org/10.4103/0976-9668.116970] [PMID: 24082718] ]. The reports showed varied resistance in different antibiotic resistance rates of various organisms along with various parts of India, as shown in Table 1 .

AMR in the world and emergence of newer Multi-Drug Resistant (MDR) and Extreme Drug Resistance (XDR) strains pose newer diagnostic and therapeutic challenges [ 33 Patil K, Bagade S, Bonde S, Sharma S, Saraogi G.

Recent therapeutic approaches for the management of tuberculosis: Challenges and opportunities. [http://dx.doi.org/10.1016/j.biopha.2018.01.115] [PMID: 29710471] ]. However, developed and developing countries are still striving to combat deep-rooted diseases such as tuberculosis, malaria and cholera pathogens, which are becoming with more drug resistant strains [ 34 John TJ, Dandona L, Sharma VP, Kakkar M.

Continuing challenge of infectious diseases in India.

[http://dx.doi.org/10.1016/S0140-6736(10)61265-2] [PMID: 21227500] ].

Several factors such as poverty, illiteracy, overcrowding and malnutrition further contribute to such kind of situation [ 35 Bajpai V.

The challenges confronting public hospitals in India, their origins, and possible solutions.

Lower healthcare professional to patient ratios is also involved for such kind of concern. CASE STUDIES OF RESISTANCE DEVELOPMENT AND AFFECTING FACTORS.

A study published by the Indian Council of Medical Research (ICMR) has found antibiotic resistant organisms of the digestive tracts in about 66% of the Indian population.

The study was performed on 207 individuals with an analysis of stool samples, who had not taken any antibiotic from at least last month. Individuals selected were not suffering from any chronic illness.

Isolates taken from 139 out of these 207 individuals were found to be resistant to one or more types of antibiotic classes. The maximum resistance

rate

Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community.

[http://dx.doi.org/10.4103/ijmr.IJMR_207_18] [PMID: 31219094] ]. A group of All India Institute of Medical Science (AIIMS), New Delhi, India researcher analyzed the water samples from seven different places in Delhi NCR regions along with the river, including its entry and exit points in the city, 35 bore wells and water percolating through waste. They found the concentration of dissolved drugs/antibiotics in the river water increased at an exit point rather than an entry point into the city. This case story concludes that either stopping or recommended use of the drugs/antibiotics by humans, animals and proper disposal method needs to be recommended to save the environment and welfare [ 37 Velpandian T, Halder N, Nath M, et al.

Un-segregated waste disposal: an alarming threat of antimicrobials in surface and ground water sources in Delhi. [http://dx.doi.org/10.1007/s11356-018-2927-9] [PMID: 30136185] ]. Resistances against various classes of antibiotics were detected among various parts of the world [ 38 Global Antibiotic Resistance Partnership (GARP)-India Working Group, 2011.

Rationalizing antibiotic use to limit antibiotic resistance in India The Indian journal of medical research 2011; 134(3): 281. However, the main reasons for this situation are either antibiotic doses not used under prescription or with proper treatment duration [ 18 Thong BYH.

[http://dx.doi.org/10.4168/aair.2010.2.2.77] [PMID: 20358021] , 38 Global Antibiotic Resistance Partnership (GARP)-India Working Group, 2011.

Rationalizing antibiotic use to limit antibiotic resistance in India The Indian journal of medical research 2011; 134(3): 281.

, 39 Gawande U, Deshmukh S, Kadam S, Potdar G, Salvitthal H. Prescription audit of patients attendees in public health facilities in Maharashtra, India with special reference to rational use of antibiotics.

[http://dx.doi.org/10.18203/2320-6012.ijrms20151418] ]. Increasing antimicrobial resistance is now a worldwide problem, compounded by the lack of development of new antimicrobial medicines [ 40 Reardon S.

[http://dx.doi.org/10.1038/509141a] [PMID: 24805322] ].

Penicillin medication is used to treat several kinds of bacterial infections.

It is also used for the treatment of a number of infections like pneumonia, bronchitis, gonorrhea and infections of the ears, nose, throat, urinary tract and skin [ 41 Venkatesh S, Chauhan LS, Gadpayle AK, Jain TS, Ghafur A, Wattal C.

National treatment guidelines for antimicrobial use in infectious diseases.

India: National Centre For Disease Control, MOHFW, Government of India 2011; 1-64. Such type of treatments led to develop a resistance and side-effects against the penicillin class of drugs, when un-appropriate doses are given with no medical healthcare supervision/guidance [ 42 Miller EL.

[http://dx.doi.org/10.1016/S1526-9523(02)00330-6] [PMID: 12484664] ]. The antibiotic should be prescribed only in case of bacterial infections, when the symptoms are severe, high risk of complications, and infection is not resolving [ 43 Reese RE,

Betts

Furthermore, in the case of severe infections, combinations therapy of antibiotics should be followed to achieve the synergistic effect of antibiotics at a lower dose under medical amoxicillin use for abortion supervision.

To prevent the development of antibiotic resistance, it is important to use antibiotics in the right way, to use the right drug with the right dose, at the right time for the right duration as per disease condition after diagnosis [ 44 Doron S,

Davidson

[http://dx.doi.org/10.4065/mcp.2011.0358] [PMID: 22033257] ].

Prescribe the drug only where necessary, and consider benefits versus risks according to patient. The dosage should be prescribed carefully and be followed by manufacturer’s instructions [ 45 De Vries TPG, Henning RH, Hogerzeil HV, Fresle DA, Policy M. Guide to good prescribing: a practical manual (No WHO/DAP/9411) 1994. The manufacture recommended doses are determined using clinical trial studies and assume one dose fits all [ 46 Shen J, Swift B, Mamelok R, Pine S, Sinclair J, Attar M.

Design and Conduct Considerations for First-in-Human Trials. [http://dx.doi.org/10.1111/cts.12582] [PMID: 30048046] ].

The newer drugs are launched and necessary to review the patient to assess for effect, side-effects (Adverse Event; AE and Serious Adverse Events; SAE) and the need to continue [ 47 Gliklich RE, Dreyer NA, Leavy MB. Adverse event detection, processing, and reporting.Registries for Evaluating Patient Outcomes: A User’s Guide 3 rd ed. Antibiotics are life-saving drugs, should be used safely and effectively [ 48 Centers for Disease Control and Prevention (CDC) and Aware. During the entire course of any prescribed antibiotic, complete the course so that it can be fully effective and does not induce resistance [ 49 National Collaborating Centre for Women’s and Children’s Health.

Antibiotics for early-onset neonatal infection: antibiotics for the prevention and treatment of early-onset neonatal infection 2012. It is required that necessary precautions should be taken by health care professionals to minimize the unnecessary prescribing and overprescribing of antibiotics [ 48 Centers for Disease Control and Prevention (CDC) and Aware. , 50 Fleming-Dutra KE, Linder JA, Hyun D, Iskander JK, Thorpe P, Laird S.

Many antibiotics such as amoxicillin, ampicillin, cephalosporin, etc .

cause mild side effects such as diarrhea and abdominal pain, and need to be prescribed with appropriate stomach care supplement or probiotics [ 51 Visone DNP. The Use of Probiotics to Prevent Antibiotic Associated Diarrhea: Current Primary Care Practice and Introduction of an Evidence Based Practice Protocol 2012.