Name: Sandrino, Rafael Ronan Ryan P.

Section: 2NU07

Answer the following questions based on the documentary given below:

https://www.pbs.org/wgbh/frontline/film/trouble-with-antibiotics/

Format:

Calibri size 11. Save completed file in PDF format, with Filename:
2NU0x_SURNAME_NAME_AntiinfectiveActivity

Deadline is on Wednesday, October 14, 2020 11:59:59PM

Guide questions on antibiotic resistance

1. What is antibiotic resistance?

-Antibiotic resistance is the emergence and spread of any bacteria that are increasingly resistant
to antibiotics. They resist the effects of antibiotic. It occurs when bacteria change in a way that
it reduces or eliminates the effectiveness of drugs, chemicals or other agents assigned to treat
or prevent infections. Antibiotic resistance occurs when the bacteria are fighting back and are
defeating the administered drug. According to the documentary, a well-known deadly-antibiotic
resistant bacterium such as superbugs are resistant even to the strongest antibiotics, which go
by names KPC and NDM 1. These bacteria are identified as relentless and persistent when it
comes to spreading and taking in multiple forms. They are being fueled by the overuse of
antibiotics, creating bugs and bacteria we cannot eliminate.

2. Why does antibiotic resistance happen?

-Antibiotic resistance occurs when a human or animal overuses the substance of antibiotics in its
system. If a person or animal rely too much on antibiotics, it builds and fuels its own resistance.
However, according to the video, some antibiotic drugs are quite valuable for treating certain
diseases and illnesses. It has a purpose for both human and animal use. They are greatly being
used in industrial-scale farming and for research purposes in treating human infections. For
example, an important antibiotic called Cephalosporin, researchers mentioned that these are
critically important and being used to treat Salmonellosis in children and pregnant women. They
are one of only few choices to treat this infection. Conversely, it is losing its effectiveness in
cattle or for animal use where bacteria were being resistance to it. Resistance went up to
Cephalosporin, making it unsafe for cattle. The use of antibiotics can potentially accelerate the
overall spread of antibiotic resistance in which they can expand resistance to critically important
drugs. Overuse of antibiotics can cause drug-resistant pathogens that can go on and cause a
drug-resistant infection. Antibiotic resistance is the unintended consequence of antibiotics that
can cause deadly infections by being loaded with antibiotic-resistant bacteria loaded with genes
that can transfer back and forth to each other.
3. Where do you find resistant bacteria?
-According to the documentary, resistance occurs everywhere in everything that they test.
Meaning, there is a potential or probability of having resistance when a living creature uses it.
You can find resistant bacteria in cattle, pigs, in chickens, in humans, and even in the retail meat
that we consume. Anywhere you use antibiotics, you are going to have resistance and propagate
resistance. Moreover, the documentary tackled how resistant bacteria comes from the
industrial agriculture, specifically in farms where chickens, pigs, and cattle are populated. These
bacteria exist and spread out in the said environment where they can proliferate and live. In the
documentary, researchers mentioned that manures are filled with antibiotic-resistant bacteria
loaded with genes that the bacteria can transfer back and forth to each other. It can also be
transmitted to its surrounding environment imposing risk factors to nearby households and
families. It can go travel airborne or could be washed off into the drainage and to the fields.
Antibiotic resistant bacteria begin with creatures who are using antibiotics, which is very
essential to industrial-scale farming. It could potentially be found in food animal productions
and huge feeding animal operations. Antibiotic resistance is going to come more from human
use than animal use. In addition, resistance also arises in animal productivity in which drugs are
being used in their foods, fueling the antibiotic resistance of the bacteria, imposing a long-term
problem to our economy.

4. Does finding resistant bacteria on a farm or in food mean there has been misuse of anitbiotics?
-Based on my observations and from what I have understood throughout the whole
documentary, I think that antibiotics are serving its purpose accordingly. We cannot blame
entirely the farming industry for utilizing the use of antibiotics and generalizing that they cause
antibiotic resistance to be transmitted. Antibiotic resistance is a natural phenomenon where
resistance exists in humans, environment, on farms, in our homes and even on our animals. It is
found everywhere since resistance happens naturally. Bacteria are living organisms and it is part
of their defense mechanism to protect and adapt to through them against these chemicals that
attack them. Resistant bacteria are millions of years old and they have been found in the ice
caps and frozen remains for centuries. Bacteria has different classifications where some has
greater chances of survival than those who are susceptible to be killed. Some are naturally
resistant to certain types of antibiotics as they evolve or mutate to deactivate antibiotics or push
them back out of the cell when it attacks. The farming or meat industry are not solely
responsible for the presence of resistant bacteria. It doesn’t necessarily mean that there has
been a misuse of antibiotics for they believe that antibiotics allows them to suppress the
transmission of diseases between their livestock and the consumers. However, misuse of
antibiotics can be considered when these huge industries attempt to overuse it. It allows the
bacteria to resist and adapt to these antibiotics in which in time they can survive the threats that
are thrown to them. Bacterial populations can also move around via introduction of animals
from other farms or via carrier species. It does not always mean that it is directly attributable to
practices on any farm. The only thing that is a potential threat that we should take notice of is
on how farming industry should start collecting data on how many antibiotics were being used
in the farm or for what purpose. According to the video, they are not collecting data to verify
that people are changing the way they are using antibiotics. There is no data that shows the
volume of antibiotics that are used for humans as compared to animals, the data are only based
 on drugs that are being sold not on used or how they are used. This could lead to a huge health
threat to increase the chances of antibiotic resistance since both organisms: human and animals
are being highly-dependent on antibiotics by demand, and we share the same environment. The
bacteria that we find in animals can also be found in people and vice versa.

5. How do you usually use an antibiotic? What is the use of prophylaxis and therapeutic
treatments?
-Antibiotics are medicinal drugs that can be administered orally or intravenously. Healthcare
professionals administer this to combat bacteria or virus from spreading and causing severe
infection on its host. In hospitals, antibiotics are being used for human treatment for curing
illnesses that are driven by bacteria and are capable of transmission from one person to
another. Antibiotics eliminate its detrimental structure and prevent them from proliferating
inside the persons body, ceasing its ability to take over and cause further harmful effects or
even death. Even for animal use, antibiotics are being used for the same type of reason.
According to the documentary, antibiotics are being used in farms to prevent spreading of
infection or disease. It is being mixed in their drinking water or even in food. Looking back in
history, the widespread use of antibiotics in farms goes back in decades, in 1940’s. For example,
Teramycin are being injected to chicken that allows increase in growth for about 15%. This only
means that for animal use, it is not only limited for therapeutic regimen but also to increase the
animal’s productivity, faster growth and keeping them healthy. Reducing a loss in their illnesses
and maintaining their weight even though they are being fed less. Antibiotics as prophylaxis
reduces the incidence off postoperative surgical site infection. It can be viewed as a precaution
to prevent, rather than treat an infection. It is a preventive treatment that can be used prior or
post operations to prevent a disease from occurring. It minimizes subsequent development of
bacterial infection for patients with high infection rates. It also prevents transmission of
communicable pathogens to susceptible contacts. Antibiotics as therapeutic treatments refers
to their function to cure ill state of animals or human. They work by killing bacteria or
preventing them from reproducing and spreading. They act by selectively killing or inhibiting the
growth of bacteria at the site of infection.

6. Based on the statistics, what is the status of antibiotic resistance in the Philippines?
-According to statistics and research, there is a frequent use of antibiotics among low-economic
status populations in the Philippines, such as in Manila. According to the research conducted by
Saito et al., 2015, there is a widespread unregulated use of antibiotics without medical
consultation in low-economic status population in the Philippines. This contributes to the
burden of antibiotic resistance in Southeast Asian countries where there is an increase of
unnecessary antibiotic use before hospital consultation. There is a relationship between
economic status and antibiotic use where promulgation of bacterial resistance increases in
different populations. In the Philippines, the unregulated sale of antibiotics without medical
prescription is widespread. Even those with a low-income can afford to purchase low-priced
generic antibiotics without a medical consultation. People may prefer antibiotics over the
counter because of the possible additional costs, efforts, and time incurred when visiting health
facilities. The widespread use of antibiotics before medical consultation can result in a
significantly lower yield of the causative pathogen in microbiology tests. Their research
 identified that the lowest-income group was more likely to use antibiotics compared with other
groups from different social sectors. That is why most Filipinos are increasingly susceptible to
bacterial infections because of their too much dependency and reliance to antibiotics serving at
as their immediate medication. They lack background information on when and how to use it,
some respondents even use antibiotics when dealing with fever and cough. It is clear that they
are not informed regarding the fact that antibiotics won’t treat viral infections because they
can’t kill viruses. This reflects on how antibacterial resistance continues to emerge in our
country and most citizens continue to suffer from bacterial diseases such as MRSA, tuberculosis,
gonorrhoea and risks of any surgery.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5953362/#b10

7. As a nurse, how will you promote safe administration of antibiotics? Give at least 3 nursing
actions.
-As nurses, it is our duty to provide the optimal health care to our patients. Health education or
patient teaching is necessary, allowing transparency and appropriate interventions based on
their needs. As nurses, we should orient the patients that they should not demand antibiotics
unless a professional says the drugs are needed. Health care professionals only prescribe
antibiotics only for infections that they believe to be caused by bacteria, not by virus. As nurses
we should demonstrate the antibiotic stewardship to reduce the development of antibiotic
resistance. Patient-education takes place to prevent further health casualties. Nursing actions
are as follows:
 Make sure your patients know to take their antibiotics with food, preferably at
mealtimes.
- Many antibiotics can upset the stomach or cause gastritis, so avoid taking them on
an empty stomach. (There are some antibiotics that can be taken with an empty
stomach, hence inform the patient about these drugs.) A heavy meal is not
necessary, but a small snack can prevent indigestion. Still, follow the instructions
correctly for the medication to be effective.
 It is imperative that the patient take the full bottle or dispensed amount, even if they
start feeling better before completion.
- Feeling better is not an indication that the bacteria are all gone. Patients who do not
complete their entire prescription help promote antibiotic resistance, because any
bacteria not killed yet can go on to reproduce with genes that allow them to avoid
destruction by common antibiotics. Drug withdrawal must not be encouraged.
 If the patient has a reaction to an antibiotic, he or she needs to call their doctor
immediately.
- Several antibiotics can cause rashes or hives, or more seriously, an anaphylactic
response. It is important to teach your patients to be on alert if it is a medication
they’ve never taken before or if they have had reactions in the past.
 Ensure allergies are documented and checked before administering antibiotics
- Poor documentation of allergies and intolerances can result in the administration of
inappropriate medicines to patients, with potentially fatal consequences.
 Promote recording of intended antibiotic duration on medicines kardexes
- Antibiotics in hospitals are often continued unnecessarily because clinicians caring
for the patient do not have information indicating why the antibiotics were
commenced and how long they were planned to be continued. Ensuring that all
antibiotic prescriptions are always accompanied by an indication and a clear
duration or review date will help clinicians change or stop therapy when
appropriate.