Antimicrobial Classes and Resistance

Introduction

It should be noted that antimicrobial classes are a group of microbicides, each of which is characterized by its spectrum of action, indications for use, and the presence of particular side effects. This substance category is of natural or semisynthetic origin. Each substance is produced by extracting it from the colonies of fungi, bacteria, plant, or animal tissue (Chisholm-Burns et al., 2015).

Differentiation

Antibacterial classes can be divided into two categories depending on their effect on the microorganisms:

1. Bactericidal (kills microbes);
2. Bacteriostatic (prevents the proliferation of microorganisms). In this case, the patient’s immune system inhibits the bacteria).

Each antibiotic works in a special way. For instance, some substances interfere with the synthesis of nucleic acids; others inhibit bacterial cell wall synthesis (Adams, Holland, & Urban, 2013). Also, certain antibiotics disturb the synthesis of proteins or block the function of respiratory enzymes. Despite the wide variety of classes, the substances can be classified based on their chemical structure. The differences between the various classes are reflected in their effectiveness. In particular, the later generation classes have a greater antibacterial activity spectrum; respectively, they are more effective. Here are some subcategories of antibacterial classes (Loeffelholz, 2014):

1. Penicillin derivatives;
2. Cephalosporin produced by fungi of the genus Cephalosporium that kills microorganisms;
3. Macrolides – substances with a complex chemical structure; it has a bacteriostatic effect on a wide range of microbes. This class must be one of the safest. It can also penetrate the human cells;
4. Aminoglycosides are effective against most aerobic gram-negative organisms. However, they are extremely toxic and cause serious complications;
5. Tetracycline (semi-synthetic and synthetic). Despite its efficacy, its disadvantage is the cross-resistance. In particular, the microorganisms that have developed resistance to one drug will be insensitive to other substances of this group.

In general, there are many subtypes of antimicrobial agents, but many of them are no longer produced due to their high toxicity.

Resistance

It is essential to cover another issue related to antimicrobial classes, which is their resistance. Resistance is one of the leading healthcare problems; meanwhile, tolerance to the substances in the leading area for innovation and nursing research. The mechanisms of microorganisms’ resistance are complex and may be linked to several reasons, for example:

• When the active antibiotic form is transformed into inactive one due to enzymatic modification;
• If the substance loses the permeability of the cell wall to a particular substance;
• When there are disturbances in the system-specific transport of the drug into the bacterial cell;
• When there is an alternative way for the microorganism to reach a metabolite product.

In this regard, the education and knowledge of nurses become the leading aspects as drug resistance may occur due to improper or inefficient use of antibacterial classes for the treatment or prevention of diseases (Hay, Levin, Deterding, & Abzug, 2016). Moreover, it may occur due to the patients’ unawareness of foods and their interactions with drugs. For example, poultry meat containing tetracycline might have a significant impact on the effectiveness of an antibiotic.

Research and Nurse Education

The role of nurses in resistance research is increasing. Medical personnel should conduct surveillance of antimicrobial use and monitor the infectious disease status of their institution to facilitate research. The ease of transmission of infectious diseases is growing; therefore, specialists should be able to select the method of treatment correctly and record any deviations (Kasper & Fauci, 2016). However, the barriers to research in this area are certain financial and technological constraints. Not all organizations, systems, and even countries can actively participate in global initiatives. In this regard, it is necessary to train personnel to promote preventive measures and practices such as monitoring and adherence to specific treatment protocols (Tamma, 2014). In general, monitoring should be carried out on the local and international levels to guide clinical management and infection control, to check the basic principles of treatment, and to update lists of essential drugs. Lastly, yet importantly, medical staff should promptly exchange information for an early warning of new forms of resistance.

References

Adams, M. P., Holland, N., & Urban, C. (2013). Pharmacology for nurses: A pathophysiologic approach. New York, NY: Pearson Higher Education.

Chisholm-Burns, M., Schwinghammer, T., Wells, B., Malone, P., DiPiro, J., & Kolesar, J. (2015). Pharmacotherapy principles and practice. New York, NY: McGraw Hill Professional.

Hay, W., Levin, M., Deterding, R., & Abzug, M. (2016). Current diagnosis and treatment pediatrics. New York, NY: McGraw Hill Professional.

Kasper, D., & Fauci, A. (2016). Harrison’s infectious diseases. New York, NY: McGraw Hill Professional.

Loeffelholz, M. (2014). Respiratory infections. London, UK: Elsevier.

Tamma, P. (2014). Antimicrobial stewardship. London, UK: Elsevier.