Man vs. Microbe
Ever-shifting warfront
SINCE 1928, humans have been more concerned about the harmful bacteria, fungi, and viruses that are pathogenic in nature. That is. they have the ability to adversely affect the human body and cause diseases of various kinds. The year is important in that while working at St. Mary's Hospital in London, Alexander Fleming discovered and isolated penicillinthe first medicine to combat illnesses caused by microbes. Earlier in 1896, a French medical student Ernest Duchesne incidentally observed the spontaneous dispersal of a substance from a fungus for self-defense against other tiny organisms that surrounded the structure. It is kind of a 'biological and chemical warfare' among the microbes still going on in their kingdom! The biochemical 'weapons' they generate for protection of self from other microbes became the key resources of humans to manufacture drugs to combat infections. Following a series of studies on penicillin, its actual use as an antibiotic started in the 1940s after isolation of its active medicinal ingredients by Howard Florey and Ernst Chain who also developed the medicine in its powdery form. The later half of the 20th century saw a rapid advancement in the discovery and production of other classes of antibiotics that include: Cephalosporins, Aminoglycosides, Macrolides, Sulfonamides, Fluoroquinolones, Tetracyclines, Polypeptides, etc., with several subclasses and types showing case-specific efficacies. Once attacked by a microbe, the human immune system develops antibodies to resist future attacks by the same species. Following this mechanism, formation of antibodies is now induced in humans through vaccination. Against these human efforts, the opponents (microbes) are also constantly changing their strategies to grow resistance against drugs because they require newer hosts for survival. By a simple genetic change in their cells through various self-mechanisms including mutation, some microbes can emerge as new strains with an ability to overcome the efficacy of drugs. This alarming situation of antimicrobial resistance has been a headache of medical scientists during the last few decades. Most medical scientists attribute this to the improper use of antibiotics, especially in the developing world, including Bangladesh, where patients are often seen not to complete the full course of antibiotics prescribed, partly due to poor buying-capacity and partly for the lack of awareness. After intake of an antibiotic by a patient, the disease-causing organisms inside the body initiate a struggle for their survival. If antibiotics are stopped before the full course is completed, the narrowly-escaped microbes in their new generations emerge as stronger strains to cause infections even in the same patient again and again. In this horrifying situation, the global community of medical scientists established the US-based Alliance for Prudent Use of Antibiotics (APUA) in 1981 to address the emerging problems of drug-resistance among the microbes by at least stopping the misuse of antibiotics. We never know whether our opponentsthe microbeshave such an 'alliance' to set newer strategies in their battle against mankind. It's now time for us to wait and see who win the battlewe or the microbes which can send us back to the pre-penicillin era to die helplessly from complications of a simple infection!
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