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9.1 Introduction
The discovery of antibiotics is considered one of the greatest medical advances in
the modern age. The antibiotics are a crucial line of defense against bacterial infections (Tang et al. 2014; Munita and Arias 2016). Alexander Fleming discovered
penicillin in 1928 accidentally and since then and onwards, the research for new
antibiotics is a continuous process (Vellar 2002). After the introduction of sulfonamides in the 1930s, antibiotic use increased exponentially and they became along
the time an integral part of health care practice worldwide (Rodriguez-Mozaz et al.
2015; Selgelid 2007). Indeed, antibiotics are regarded as “panacea” of modern medicine (Penchovsky and Traykovska 2015). Undoubtedly, they contributed to the
increase of the human lifespan in comparison to the pre antibiotic era, when infectious diseases were fatal for many humans.
However, every introduction of a new antibiotic is followed sooner or later by the
emergence of antimicrobial resistance (McPhee et al. 2009). The emergence of antimicrobial resistance was recognized since the beginning of the antibiotic era. After
the introduction of the first antibiotics, there was a belief that with their use, all
infectious diseases eventually will belong to the past. Unfortunately, this is not the
case due to the emergence of antimicrobial resistance against any antibiotic.
Therefore, antimicrobial resistance is considered one of the biggest threats to public
health in the twenty-first century worldwide. The development of antimicrobial
resistance is observed mostly in countries where antibiotics use is high and is not
properly controlled. Unfortunately, the rapid development of antimicrobial resistance may reverse previous medical progress and bring to light infections from the
past. The antibiotics were used successfully against many bacterial infections in the
past, rendering them now ineffective for the treatment of those infections nowadays
due to antimicrobial resistance development (Munita and Arias 2016; RodriguezMozaz et al. 2015; Mayers et al. 2017; Garau et al. 2014). The rise in the income of
people who live in developing countries leads to easier access to antibiotics which
also contributes to the increase of antibiotic use and therefore the development of
antimicrobial resistance (Selgelid 2007).
9.2 Antibiotics Misuse
The overuse along with the misuse of antibiotics in human and veterinary medicine,
agriculture, and aquaculture are some of the reasons deemed for antimicrobial resistance development. Antibiotics are a category of drugs used in daily practice.
Sometimes, due to the absence of diagnostic tools or due to the time needed for the
confirmation of a pathogen, physicians start the treatment with the use of empiric
therapies based on clinical symptoms and the individual characteristics of a patient.
This may lead to the prescription of antibiotics not only against bacterial agents but
sometimes wrongly against non bacterial agents. However, in critically ill patients
A. Valsamatzi-Panagiotou et al.
9.1 Introduction
The discovery of antibiotics is considered one of the greatest medical advances in
the modern age. The antibiotics are a crucial line of defense against bacterial infections (Tang et al. 2014; Munita and Arias 2016). Alexander Fleming discovered
penicillin in 1928 accidentally and since then and onwards, the research for new
antibiotics is a continuous process (Vellar 2002). After the introduction of sulfonamides in the 1930s, antibiotic use increased exponentially and they became along
the time an integral part of health care practice worldwide (Rodriguez-Mozaz et al.
2015; Selgelid 2007). Indeed, antibiotics are regarded as “panacea” of modern medicine (Penchovsky and Traykovska 2015). Undoubtedly, they contributed to the
increase of the human lifespan in comparison to the pre antibiotic era, when infectious diseases were fatal for many humans.
However, every introduction of a new antibiotic is followed sooner or later by the
emergence of antimicrobial resistance (McPhee et al. 2009). The emergence of antimicrobial resistance was recognized since the beginning of the antibiotic era. After
the introduction of the first antibiotics, there was a belief that with their use, all
infectious diseases eventually will belong to the past. Unfortunately, this is not the
case due to the emergence of antimicrobial resistance against any antibiotic.
Therefore, antimicrobial resistance is considered one of the biggest threats to public
health in the twenty-first century worldwide. The development of antimicrobial
resistance is observed mostly in countries where antibiotics use is high and is not
properly controlled. Unfortunately, the rapid development of antimicrobial resistance may reverse previous medical progress and bring to light infections from the
past. The antibiotics were used successfully against many bacterial infections in the
past, rendering them now ineffective for the treatment of those infections nowadays
due to antimicrobial resistance development (Munita and Arias 2016; RodriguezMozaz et al. 2015; Mayers et al. 2017; Garau et al. 2014). The rise in the income of
people who live in developing countries leads to easier access to antibiotics which
also contributes to the increase of antibiotic use and therefore the development of
antimicrobial resistance (Selgelid 2007).
9.2 Antibiotics Misuse
The overuse along with the misuse of antibiotics in human and veterinary medicine,
agriculture, and aquaculture are some of the reasons deemed for antimicrobial resistance development. Antibiotics are a category of drugs used in daily practice.
Sometimes, due to the absence of diagnostic tools or due to the time needed for the
confirmation of a pathogen, physicians start the treatment with the use of empiric
therapies based on clinical symptoms and the individual characteristics of a patient.
This may lead to the prescription of antibiotics not only against bacterial agents but
sometimes wrongly against non bacterial agents. However, in critically ill patients
A. Valsamatzi-Panagiotou et al.