Antibiotic Resistance and Learning Medicine: Could They be The Same?
Learning medicine using body system-based modules is very common in many medical schools. These are the modules that must be passed through to get myself into the clinical stage of medical school.
Genetics and Molecular Biology. Immunology. Neuroscience. Growth and Development. Dermatology and Musculoskeletal. Gastroenterology and Hepatobiliary. Kidney and Body Fluids. Cardiology and Vascular. Respiratory. Metabolic Endocrine. Reproductive System. Neurology and Psychiatry. Tropical Infection. Special Senses. Hematology and Oncology.
The difficult part is not about passing a module; it is the after-module phase. When immunology module is passed, going to neuroscience module, and so on. Until I realize that once I am in the tropical infection module, I already forgot the immunology one. And that is just frustrating.
One day, I was in this discussion; talking about the severity of antibiotic resistance, especially in Indonesia. It is so severe that pathogens are resistant to almost all kind of new generation antibiotics. And for the antibiotic and drug researchers, this is a race against time to develop some new ones.
The resistance of pathogen to certain antibiotics is due to some known mechanism;
1. Â Â Intrinsic factor of bacteria, means there are no target molecule of antibiotic in the bacteria.
2. Â Â Chromosomal factor, means the bacteria is having some genes in its chromosome to produce enzymes that disable the antibiotics.
3. Â Â Plasmid, just like the chromosomal factor but this one is from free âfloatingâ genes taken by bacteria from its environment or other bacteria.
From the theory of natural selection, when antibiotic is given to colony of bacteria, there would be some susceptible ones that would be eliminated, leaving the resistant bacteria alive. When this happen for many times, there would be no antibiotic-sensitive bacteria left, and the resistant one would grow, multiplying it selves, ending up as a colony that resistant to that antibiotic. The resistance of bacteria to antibiotics develops faster and faster, from one antibiotic class to another.
I wonder if the resistance mechanism is working like how I face a module. Letâs say that I am once âsensitiveâ to immunology module, that I desperately working hard to hold on and pass the module, then I become âresistantâ to immunology module. But the Medical School Curriculum Unit did not give up to âstopâ me, they gave me another âantibioticâ (re: new modules) I am âsensitiveâ to. And that happen again and again, until one time, the Curriculum Unit has no module left to be given to me. So, they use the immunology module, or another first modules, against me, and I found myself already forget them, so that I am once more time, become âsensitiveâ to that module.
If that could happen in the bacteria as it happens to me, there is a chance that first generations antibiotics that are now abandoned, would someday be effective again against bacteria in the future (I think i've heard some new research findings about this, but it is still inconclusive). Just like the first modules become effective against me after a long time has passed. Who knows? :)
Disclaimer: This doesnât mean that we could continue using antibiotics unconcern just like now, this is our task to correct it together. This also doesnât justify the act of forgetting lessons we have learned in the past, we should repeat and re-read them, so that the knowledge is preserved in our head. Hope you enjoy this ârandom thoughtâ article.