Journey of microbes and antimicrobials (Dr. Parthsarathy oration at NCPID 2010, Kochi)

Microbes are here in the world more than 1 billion years before human beings. They are important for the human race. Very few pathogenic microbes are problematic. Antibiotics are developed to kill microorganisms; however, microorganisms develop and disseminate resistance as a reaction to antimicrobials in accordance with the laws of evolution and natural selection. Resistant and multidrug-resistant bacterial infections comprise a great problem in both the community and hospital setting. Increasing values of health expenditures, including antibiotics, is a global problem. Antibiotic resistance is not always, but usually, associated with significant morbidity, longer hospitalization, excess costs and mortality. Newer antibiotics are very few in pipeline. Optimal use of existing antimicrobial agents, using alternative treatment options (where possible), reducing the need for antimicrobials by increasing immunity, reducing the use of antimicrobials without providing an alternative form of treatment through education of health professionals and patients, antibiotic policies (including antibiotic stewardship and regulations for restricted use), implementation of infection control measures (e.g., hand washing, screening and isolation) are the strategies aimed at prevention of emergence and spread of antibiotic resistance.