Abstract

Godfrey B. S. Iyalomhe*, Sarah I. Iyalomhe and Richard E. Eholor

Worldwide, antibiotics are among the most commonly used and misused drugs because of the perception in some practitioners and patients that antibiotic resistance is theoretical or only a minor risk. This review therefore aims to update knowledge and promote proper antibiotic prescription with the goal of optimizing use and halting the trend of rising resistance. A literature and internet (Medline, embase, HINARI and Cochrane data bases) search showed that prescription of antibiotics only when indicated following standard guidelines minimizes the incidence and spread of resistance. Mechanisms of resistance development include bacterial mutation or horizontal transfer from plasmids, transposons, integrons and gene cassettes between commensal organisms and potential pathogens by transduction, translocation, transposition, transformation or conjugation. Resistance may emerge following indiscriminate use of antibiotics, unhygienic conditions, poor drug handling and non-adherence. To halt resistance, priority areas include prudent use of antibiotics; development of antimicrobials with novel mechanisms of action; use of bioinformatics and genomic techniques to identify and study new targets of attack; use of alternatives to antibiotics such as bacteriophage-derived therapy or chemical agents that can block or reverse resistance pathways; use of agents in natural products, vaccines and pro-biotics as well as implementing public health strategies and education of the populace. In response, initiatives at the local, national and international levels are now directed towards promoting good antibiotic stewardship, infection control, sanitation and hygiene practices.