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Scholarly Articles
Anti-microbial Resistance
Ms. A.D.J.L.Wickramaarachchi, AH/PH/2018/190, Department of Pharmacy
Introduction
Anti-microbial resistance (AMR) is the ability invention of anti-microbial therapies, to
of micro-organisms to survive against anti- protect themselves and to gift such protective
microbial agents which was previously an mechanisms to others of the same or different
effective treatment. Simply, it is the resistance species. However, after the invention of this
of the microbes to anti-microbial agents. It can new drug category, AMR has increased rapidly
be inherent or acquired. This is an urgent due to the irrational use of anti-microbial
global public health treat which is killing agents (Rosini et al., 2020). Alexander
thousands of humans across the world (Naimi Fleming said that “the ignorant man may
et al., 2001; Agnew et al., 2021). AMR will be easily under-dose himself and by exposing his
a global crisis and a complex, multi-sectoral, microbes to non-lethal quantities of the drug
multi-stakeholder challenge in the future make them resistant” in the speech of the
(Littmann et al., 2020). Nobel Price ceremony in 1945 (Littmann et al.,
2020).
What are anti-microbial agents?
Causes of AMR
Anti-microbials are the medicines which are
used for the prophylaxis and treatment of The evolution of resistant genes and their
infections in humans, animals and plants transmission, irrational use of anti-microbials
caused by microbes. Those include antibiotics, in human, improper use of anti-microbials in
antivirals, antifungals and anti-parasitic agents animals and agricultural systems are some of
(Naimi et al., 2001).Those can be natural, the main known causes for AMR.
synthetic or semi-synthetic compounds. Anti-
viral agents (eg: Acyclovir, Ganciclovir)and Random mutations are occurring in microbes
anti-fungal drugs (eg: Ketoconazole, to adapt to different conditions. Due to such
Clotrimazole) are present in minute amounts mutations over the number of generations,
compared to anti-bacterial agents which are microbes have gene codes that are responsible
known as antibiotics (eg: Ampicillin, for resistant mechanisms. Some species can
Vancomycin). Most anti-viral agents have transfer such gene codes horizontally.
severe side effects (eg: which are used to treat
HIV infection). The requiring effective Some patients may not be able to continue the
concentration of many anti-microbial agents drug therapy in disease conditions like
shows selective toxicity towards humans Tuberculosis (TB), which needs therapy for
(Cheesbrough, 2006). months. It leads to the underuse of anti-
microbials. Sometimes normal flora of
History of AMR microbes (especially bacteria) on and in the
body exposed to the anti-microbials during
Anti-microbial therapies were started in the both appropriate and inappropriate therapies
early 90s. Resistance mechanisms of micro- leads to their resistance. Accordingly, overuse,
organisms were there even before the underuse and even proper use for a longer
period,

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