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Preventing health care associated infections 143

Today many microorganisms are resistant to the medications that
have traditionally been used to treat the infections. This problem has
been attributed to overprescribing of antibiotics, poor patient compli-
ance in taking the antibiotics and the ability of bacteria to develop re-
sistance mechanisms through genetic alterations. It has been estimated
that up to 50% of antibiotics used in hospitals are used inappropriately
[9]. Multidrug-resistant organisms (MDROs) can cause infections in the
blood, organ systems, and on skin. MDRO infections have arisen be-
cause of over prediction and misuse of antibiotics. As microorganisms are
repeatedly exposed to a low dose of a particular antibiotic, they have
developed mechanisms that help them to fight the antibiotic. Failure to
take antibiotics as prescribed has enabled organisms to develop resistance.
Patients often stop taking the prescribed antibiotic as soon as they feel
better. The premature stoppage of the antibiotics allows the more difficult
to kill microorganisms to survive and results in the microbial population
developing a resistance. It is critical that patients complete the regimen
of prescribed medication despite the fact that they are feeling better. The
probability of the microbe developing resistance increases with the expo-
sure to antibiotics. Once developed, the resistance to the antibiotic can be
passed on to new bacteria.
There are some basic steps that can be taken to prevent antibiotic-
resistant infections. These include:
• Control of antibiotic use
• Overuse of antibiotics is a major cause of antibiotic-resistant organ-
isms. Antibiotics, often prescribed for viral infections, only increase
the exposure of the microbial population to the antibiotic because
antibiotics are not effective against viruses.
• Use of antibiotics should be targeted for specific bacterial infections.
Certain bacteria are more susceptible to specific antibiotics.
• Antibiotics must be taken as prescribed. The incredible efficacy of
antibiotics often lead to rapid symptomatic relief before the bacteria
has been eradicated. This leads patients to stop or miss prescribed
dosages because they feel better. The resultant exposure of a low re-
sidual antibiotic dose to the remaining bacteria which are more dif-
ficult to kill, is a perfect storm to develop antibiotic-resistant strains
of bacteria.
• Increased use of antibiotics in an environment where antimicrobial-
resistant bacterium already exists provides natural selective pressure
to enable these agents to flourish.