This article is about pathogen resistance to the effects of drugs. For human resistance to the effects of drugs, see Drug tolerance.
An illustrative diagram explaining drug resistance.
Drug resistance is the reduction in effectiveness of a medication such as an antimicrobial or an antineoplastic in treating a disease or condition.[1] The term is used in the context of resistance that pathogens or cancers have "acquired", that is, resistance has evolved. Antimicrobial resistance and antineoplastic resistance challenge clinical care and drive research. When an organism is resistant to more than one drug, it is said to be multidrug-resistant.
The development of antibiotic resistance in particular stems from the drugs targeting only specific bacterial molecules (almost always proteins). Because the drug is so specific, any mutation in these molecules will interfere with or negate its destructive effect, resulting in antibiotic resistance.[2] Furthermore, there is mounting concern over the abuse of antibiotics in the farming of livestock, which in the European Union alone accounts for three times the volume dispensed to humans – leading to development of super-resistant bacteria.[3][4]
Bacteria are capable of not only altering the enzyme targeted by antibiotics, but also by the use of enzymes to modify the antibiotic itself and thus neutralize it. Examples of target-altering pathogens are Staphylococcus aureus, vancomycin-resistant enterococci and macrolide-resistant Streptococcus, while examples of antibiotic-modifying microbes are Pseudomonas aeruginosa and aminoglycoside-resistant Acinetobacter baumannii.[5]
In short, the lack of concerted effort by governments and the pharmaceutical industry, together with the innate capacity of microbes to develop resistance at a rate that outpaces development of new drugs, suggests that existing strategies for developing viable, long-term anti-microbial therapies are ultimately doomed to failure. Without alternative strategies, the acquisition of drug resistance by pathogenic microorganisms looms as possibly one of the most significant public health threats facing humanity in the 21st century.[6] Some of the best alternative sources to reduce the chance of antibiotic resistance are probiotics, prebiotics, dietary fibers, enzymes, organic acids, phytogenics.[7][8]
^Alfarouk, KO; Stock, CM; Taylor, S; Walsh, M; Muddathir, AK; Verduzco, D; Bashir, AH; Mohammed, OY; Elhassan, GO; Harguindey, S; Reshkin, SJ; Ibrahim, ME; Rauch, C (2015). "Resistance to cancer chemotherapy: failure in drug response from ADME to P-gp". Cancer Cell International. 15: 71. doi:10.1186/s12935-015-0221-1. PMC 4502609. PMID 26180516.
^"Antibiotic Resistance and Evolution". detectingdesign.com. [verification needed]
^Harvey, Fiona (16 October 2016). "Use of strongest antibiotics rises to record levels on European farms". the Guardian. Retrieved 1 October 2018. [verification needed]
^Duckenfield, Joan (2011-12-30). "Antibiotic Resistance Due to Modern Agricultural Practices: An Ethical Perspective". Journal of Agricultural and Environmental Ethics. 26 (2): 333–350. doi:10.1007/s10806-011-9370-y. ISSN 1187-7863. S2CID 55736918. [verification needed]
^Fisher, Jed F.; Mobashery, Shahriar (2010). "Enzymology of Bacterial Resistance". Comprehensive Natural Products II. Volume 8: Enzymes and Enzyme Mechanisms. Elsevier. pp. 443–201. doi:10.1016/B978-008045382-8.00161-1. ISBN 978-0-08-045382-8. [verification needed]
^Institute of Medicine (US) Forum on Emerging Infections; Knobler, S. L.; Lemon, S. M.; Najafi, M.; Burroughs, T. (2003). "Summary and Assessment". Reading: The Resistance Phenomenon in Microbes and Infectious Disease Vectors: Implications for Human Health and Strategies for Containment -- Workshop Summary - The National Academies Press. doi:10.17226/10651. ISBN 978-0-309-08854-1. PMID 22649806. [verification needed]
^Jha, Rajesh; Das, Razib; Oak, Sophia; Mishra, Pravin (2020). "Probiotics (Direct-Fed Microbials) in Poultry Nutrition and Their Effects on Nutrient Utilization, Growth and Laying Performance, and Gut Health: A Systematic Review". Animals. 10 (10): 1863. doi:10.3390/ani10101863. PMC 7602066. PMID 33066185.
^Jha, Rajesh; Mishra, Pravin (2021-04-19). "Dietary fiber in poultry nutrition and their effects on nutrient utilization, performance, gut health, and on the environment: a review". Journal of Animal Science and Biotechnology. 12 (1): 51. doi:10.1186/s40104-021-00576-0. ISSN 2049-1891. PMC 8054369. PMID 33866972.
Drugresistance is the reduction in effectiveness of a medication such as an antimicrobial or an antineoplastic in treating a disease or condition. The...
Antimicrobial resistance (AMR) occurs when microbes evolve mechanisms that protect them from the effects of antimicrobials (drugs used to treat infections)...
Multiple drugresistance (MDR), multidrug resistance or multiresistance is antimicrobial resistance shown by a species of microorganism to at least one...
animals. Anthelmintic resistance in parasites is widespread; drugresistance exists in all livestock hosts and to all anthelmintic drug classes. This is a...
Drug Abuse Resistance Education, or D.A.R.E., is an education program that tries to prevent use of controlled drugs, membership in gangs, and violent...
HIV drugresistance occurs when microevolution causes virions to become tolerant to antiretroviral treatments (ART). ART can be used to successfully manage...
response in the patient. Drugresistance, such as antimicrobial resistance or antineoplastic resistance, may make the first-line drug ineffective, especially...
EF-2001 are characterized by the lack of specific genes related to drugresistance and pathogenesis. As an opportunistic pathogen, E. faecalis can cause...
antimalarial drugs have repeatedly been observed to elicit resistance in the malaria parasite—including for combination therapies featuring artemisinin, a drug of...
Such drugs are usually obtained by a doctor's prescription, but a few are available over the counter (OTC). The evolution of antifungal resistance is a...
to Airway resistance, a concept in respiratory physiology Antibiotic resistance, used for bacteria resistant to antibiotics Drugresistance, the reduction...
determines the duration and intensity of a drug's pharmacologic action. Drug metabolism also affects multidrug resistance in infectious diseases and in chemotherapy...
(MDR/TAP) family is responsible for multiple drugresistance (MDR) against a variety of structurally unrelated drugs. ABCB1 or MDR1 P-glycoprotein is also involved...
ranges. In T. mentagrophytes, antifungal drugresistance is mainly associated with Type VIII isolates. Drug-resistant T. mentagrophytes strains have been...
possibly shift as well. Antibiotic resistance applies specifically to bacteria that become resistant to antibiotics. Resistance in bacteria can arise naturally...
order to reduce the risk of spreading drugresistance, MDAs should use more than one drug and, preferably include a drug, such as an artemisinin, which has...
promote drugresistance—by converting the tumor cells back into a stem cell-like state. When the tumor cells began to exhibit drugresistance, the cells...
PMC 5996685. PMID 29686137. Ishiwa, Hiromi; Iwata, Shin (1980). "Drugresistance plasmids in Lactobacillus fermentum". The Journal of General and Applied...
prove otherwise like the Multi-DrugResistance Gene 1. MDR1 codes for the P-glycoprotein which helps get rid of drugs in the body. It is located in the...
of drug-induced liver injury. In the US only, streptomycin is not considered a first line drug by ATS/IDSA/CDC because of high rates of resistance. WHO...
and intergenic regions associated with drugresistance may be involved in the resistance to more than one drug. Noteworthy is the role of the intergenic...
replication. HCMV antiviral drugresistance can be detected by phenotypic or by genotypic drugresistance testing. Phenotypic resistance testing involves cultivation...
bacteria is inhibited by the drug. For example, antibacterial selection for strains having previously acquired antibacterial-resistance genes was demonstrated...
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