Peeping Into the Growing Menace of Antibiotics Resistance: Factors, Mechanisms and Futuristic Challenges

Antimicrobial resistance (AMR) has been a growing challenge and a global threat to human well-being. The consumption of antibiotics is on the rise despite many countermeasures to mitigate the overuse and abuse of various measures designed to mitigate antibiotic overuse and abuse. Misuse of antibiotics is among the primary reasons for the rapid spread of AMR bacteria world-wide, with India being one of the world's largest consumers of antibiotics. It is skeptical that developing new antimicrobial drugs will solve the escalating problem of antibiotic resistance. Bacteria have developed physical, molecular, and chemical mechanisms to resist any stresses of antimicrobial agents. These mechanisms have made bacteria fitter to overcome the effect or action of any antibiotics that destroy them. Various biochemical and molecular mechanisms adopted by the microbes have rendered antibiotics useless. Antibiotics such as β-lactams, fluoroquinolones, Tetracycline, and chloramphenicol have been significantly resisted due to mutational changes at the gene and protein level. Some enzymes, such as β-lactamases, Cephalosporinases, Carbapenemase enzymes, Oxacillin-hydrolyzing enzymes, Aminoglycoside modifying enzymes, Aminoglycoside Phosphotransferase, Adenyltransferases, may directly destroy the active antibiotic site or modify structural elements of antibiotics to inhibit bacterial target site interaction reducing the efficacy of the antibiotics to the bacteria. Therefore, considering the above issues, significant changes in antibiotics-enhancing targeted therapy need to be recommended. Additionally, vaccination programs, improvements in microbiological diagnostic tools, and reducing antibiotic usage without proper diagnosis would be major ways to preserve the effectiveness of antibiotics for future generations. It is also fundamental to better understand the molecular, physical, biochemical, and evolutionary factors that regulate the spread of antibiotic resistance.