Antibiotic resistance of bacterial pathogens: the magnitude of the problem from two perspectives - Romanian and worldwide

Despite the medical concerns arising from the emergence of antibiotic resistance, a regress in developing new antibiotic drugs has been registered in the past decades. Therefore, for the next years, the main objective is to slow down the development and spread of antibiotic resistance. At the same time new and alternative strategies are needed to identify novel classes of antibiotics. In this perspective, the present review aims to discuss the magnitude of the emergence of bacterial resistance to approved antibiotics. The first section briefly describes the main mechanisms of resistance an important issue to be considered for the discovery and design of new effective antibiotics. The next sections deal with the statistical information on antibiotic resistance. International surveillance studies on resistance and antibiotic consumption showed significant variation related to geographic location, type of population and community level care, sampling and analyses procedures. Despite these influences there is a worrying worldwide evolution regarding the development of resistant and multiresistant isolates of pathogens. Strategies to reduce antibiotic resistance should be adapted to each country, region and hospital database. We conclude by considering other issues, such as supervision, infection control policies and educational programs based on enhanced hygiene and decrease of the misuse and abuse of antibiotics, as equally important for the management of the resistance phenomenon.