Antibiotic resistance

Antibiotic resistance is the term used when a bacterial strain has a mechanism enabling it to evade the effects of an antibiotic. The development of resistance is exacerbated by the inappropriate prescribing of antibiotics.

Bacteria on agar plate

Strictly speaking, antibiotics are a natural part of the ecosystem. They are produced by bacteria and fungi and inhibit the growth of other microorganisms or actually kill them even at low concentrations. These substances thus confer a competitive advantage over competitors on the organisms that produce them. This effect makes antibiotics attractive as medication for combating a wide range of bacterial infections. But: In some cases, bacteria also have the ability to evade this effect. Such cases of “antibiotic resistance” are based on a wide range of mechanisms. Changes to the target structures in bacteria, inactivating proteins or reduced uptake of the antibiotic are among the reasons why medicines may not work.

How does resistance develop?

Resistance is genetically determined and develops as a result of random mutations that confer a selective advantage on the bacterium. Unlike susceptible bacteria, resistant organisms are therefore able to survive, reproduce and continue to spread despite antibiotics. This phenomenon is further magnified if medicines are administered incorrectly or in a dose that is too low. Particularly dangerous: Antibiotic resistance genes can be transferred from one bacterium to another because they are located on transferable genetic elements. If a bacterium has assimilated a number of resistance genes, it is referred to as a multidrug-resistant organism, because it has become insensitive to multiple active substances.

Resistance is a global problem

As a result of the careless and excessive use of antibiotics, the global resistance situation has been worsening for some time. Multidrug-resistant pathogens that will no longer respond to any active substance are being identified increasingly. Fear is growing that even infectious diseases that were once easily treatable may sooner or later end up being fatal again.

The causes of the development and spread of resistance include:

  • unnecessary use of antibiotics
  • inadequate dosage of the active substance
  • not taking the medication for the required period of time or taking it irregularly
  • inappropriate choice of active substance

This is why leading health organizations are called for antibiotics to be used responsibly and only after microbiological diagnostic testing.

Antibiotics in periodontal therapy

The use of antibiotics in periodontal therapy is particularly helpful in the presence of high bacterial loads and invasive bacterial species. In this context too, the responsible use of antibiotics involves verifying the spectrum of pathogens present on the basis of a microbiological analysis. Only if the composition of the microbial spectrum is known can treatment be carried out according to the principle: “as much as necessary, but as little as possible”. In this way, the numbers of periodontopathogenic bacteria can be reduced in a targeted manner and the beneficial flora spared. Inappropriate prescribing is also avoided and side effects minimized.