International Journal of Advanced Research and Development 4 International Journal of Advanced Research and Development ISSN: 2455-4030 Impact Factor: RJIF 5.24 www.advancedjournal.com Volume 3; Issue 6; November 2018; Page No. 04-08 Antimicrobial resistance: A major threat to public health Rajandeep Kaur 1* , Harpreet Singh 2 1, 2 Adesh Institute of Pharmacy and Biomedical Sciences, Adesh University, Bathinda, Punjab, India Abstract The microbial infections that once were easily treated are becoming untreatable in these days. The major cause for this problem is the growth of antimicrobial resistance among the microorganisms. Antimicrobial resistance possess serious threat to health in India and worldwide. Resistance arise through one of three ways; natural resistance in certain types of bacteria, genetic mutation or by one species acquiring resistance from another. Within four years following the introduction of Penicillin during the Second World War, occurrence of resistance strain was reported. Inappropriate or incorrect use of antimicrobial drugs and premature treatment interruption can cause drug resistance. The multiplicity and non-specificity of efflux pumps and occurrence of resistance- conferring genes in non-pathogenic bacteria hint at some other role of antibiotics in evolution. It is also believed that bacteria sense antibiotics as an environmental stress. Keywords: antimicrobial resistance, multi drug resistance, resistance mechanism 1 Introduction Antibiotics constitute one of the most significant contributions of modern science. The discovery of these lifesaving drugs transformed the health care scene during the last century. A significant decline in the fatality rate of many diseases was noticed after the introduction of antibiotics into clinical practice. For instance, 20% to 85% death rate due to Pneumonia in US during 1930 came down to about 5% in the 1960. 100% death due to chronic infection of heart value was reducing to 5%. Antibiotic help not only in curing the diseases but also in their prevention. Penicillin for instance, prevent throat infection caused by Streptococcus [1] . Many decades after the first patient were treated with antibiotic, bacterial infection have again become threat [2] . The antibiotic resistance has been attributed to overuse and misuse of these medication, as well as lack of new drug development by pharmaceutical industry due to reduce income incentives and challenging regulatory requirements [3] . Antibiotic resistance or antimicrobial resistance is the ability of microbe to resist the effects of medication previously used to treat them [4] . Resistance arise through one of three ways; natural resistance in certain types of bacteria, genetic mutation or by one species acquiring resistance from another [5] . Within four years following the introduction of Penicillin during the Second World War, occurrence of resistance strain was reported. According to an estimate by The Centers for Disease Control and Prevention (USA), 13300 patients died of antibiotic resistance bacterial infection in USA during 1992. An incredible 150% increase in the occurrence of drug resistance Pneumonia was noted between 1987 and 1994. A 20 fold increase in the frequency of hospital acquired Enterococci; resistance of Vancomycin was seen between 1989 and 1993. The frequency of Methicillin-resistance Staphylococcus score from 2% in 1975 to 32% in 1992 [6] . Bacteria, not human or animal, become antibiotic resistance. The bacteria may infect human and animal, and the infection they cause are harder to treat than those caused by non- resistant bacteria [7] . 2. History of Resistance Antibiotics were first prescribed to treat serious infections in 1940. Penicillin was successful in controlling bacterial infection among World War 2 [8] . However, shortly thereafter, Penicillin resistance became a substantial clinical problem. So that, by 1950, in response new beta-lactum antibiotics were discovered, developed and deployed, restoring confidence. However, the first case of Methicillin-resistance Staphylococcus Aureus (MRSA) was identified during that same decade in UK in 1962 and in the US in 1968 [9] . Vancomycin was introduced into clinical practice for the treatment of MRSA [10] . Streptomycin was found effective for tuberculosis in 1944 but In 1950, scientist Renee Dubos predicted that that bacteria would eventually develop resistance to antibiotics through random mutations [11] . 3. Epidemiology Antimicrobial resistance is one of the most complex global health challenges today. Multidrug-resistance tuberculosis killed as estimate 250,000 people in 2015. People with MRSA are estimate to be 64% more likely to die than people with non-resistance form of the infection. In2010, an estimate 7% of people starting antiretroviral therapy in developing countries had drug-resistance HIV, in developed countries; same figure was 10-20% [12] . In India antimicrobial resistance is high as compare to developed countries due to higher consumption of medicine. However many international agencies like WHO, European Centre For Disease Control and World Health Assembly resolution highlighted the antimicrobial resistance as a major