Abstract

Since 1940s, antibiotics have been used to treat bacterial infections. This resulted in dramatic improvement in morbidity & mortality from infectious diseases. But misuse, abuse & overuse of antibiotics lead to development of drug-resistant bacteria. Resistance to antibiotics is a complex phenomenon which is caused by a complex combination of direct & indirect impacts, such as antimicrobial misuse in humans & farm animals, environmental pollution, poor sanitation, & inherent bacterial features. Multi Drug Resistant (MDR) infection is a global problem now. Gram negative organisms constitute a major part of antibiotic resistant organisms. Infection with MDR gram negative strains results in high morbidity and mortality. It also causes increased length of stay in hospital & increased cost. Presence of co-morbidities, use of invasive equipments, less mobility, weak immune status, and exposure to high number of antibiotics enhance the susceptibility of infection with MDR pathogens in the critically ill patients in the Intensive Care Unit (ICU). Drug resistant strains of Pseudomonas aeruginosa, Klebsiella pneumonieae, Acinetobacter baumanii, and Eshcherichia coli are the common gram negative organisms that are isolated from respiratory specimens, blood, urine, pus & other body fluids from the ICU patients. Results of their sensitivity tests must be followed for antibiotic selection. Unfortunately they are resistant to most of the available antibiotics. Infectious Disease Society of America (IDSA) publishes updated guidelines to treat AMR infections. Depending on the isolated organisms, & nature & site of infection, we have to carefully choose antibiotics. We should remember that field of AMR is dynamic. Newer antibiotics are available in clinical practice, but their indiscriminate use may lead to development of resistance. Rational use of antibiotics is the key to combat antimicrobial resistance.