Multidrug resistance refers to the ability of microorganisms, especially bacteria, to become resistant to several different antibiotics or disinfectants. In short, germs become resistant and can no longer be killed with existing products. This characteristic poses a serious challenge to healthcare systems worldwide, as it makes the treatment of infections more difficult and requires the development of new drugs.

What is multidrug resistance and how can it develop?

Multidrug resistance occurs when microorganisms develop mechanisms that make them insensitive to a wide range of antimicrobial products. These resistant germs are often referred to as multi-resistant organisms (MRE). The best known examples are methicillin-resistant Staphylococcus aureus (MRSA) and multi-resistant gram-negative bacteria such as Escherichiacoli or Klebsiella pneumoniae.

Klebsiella pneumoniae (bacterial pneumonia)

These resistances can develop through genetic mutations or the exchange of resistance genes between microorganisms. This often occurs when small pieces of DNA, such as plasmids, are transferred between different types of bacteria.

The main causes of the emergence and spread of multidrug resistance are:

1.Excessive use of antibiotics:

Antibiotics are often used inappropriately or unnecessarily in both human and veterinary medicine.

2. Incomplete treatment cycles:

Bacteria can survive and develop resistance if patients do not take antibiotics as prescribed.

3. Incorrect cleaning:

Especially in hospitals and healthcare facilities, where many pathogens congregate, improper cleaning or disinfection can encourage the spread of resistant pathogens.

4. Environmental factors:

Antibiotic residues in wastewater and soil can also promote the development of resistance.

Antibiotics and their role in multidrug resistance

Antibiotics are the most important weapon against bacterial infections. However, their inappropriate use is the main cause for the development of resistance.

Common problems are:


Broad-spectrum antibiotics: They are effective against many strains of bacteria, but also destroy beneficial microbes and thus promote the survival of resistant germs.

Use in Livestock Farming: In agriculture, antibiotics are often used as growth promoters, which can lead to resistance in environmental bacteria that can be transferred to humans.

Developing new antibiotics is time-consuming and cost-intensive, so innovation is not keeping pace with the spread of resistant bacteria. In addition, new antibiotics are held in reserve for years and only used when existing antibiotics are no longer effective. This makes development unprofitable for many large companies, as no sales can be expected for years or even decades.

Disinfectants and multi-resistance

Disinfectants also play a role in resistance development. If disinfectants are used incorrectly or at too low a concentration, bacteria can develop resistance mechanisms. A well-known example is resistance to quaternary ammonium compounds which are found in many disinfectants.

Important measures for prevention are:



• Use effective disinfectants at the proper concentration and recommended exposure time.


• Provide regular training for staff in health care facilities.

Conclusion: What can be done?

Alternative treatment option: Phage therapy

Combating multidrug resistance requires a holistic approach:

Responsible use of antibiotics: Doctors, farmers and patients must be made aware that antibiotics should only be used when necessary and as prescribed.

Promoting hygiene: Strict hygiene measures in hospitals can curb the spread of multi-resistant pathogens.

Research and innovation: Investment is needed in the development of new antibiotics, diagnostic technologies and alternatives such as phage therapy. Phage therapy uses bacteriophages (viruses that specifically kill disease-causing bacteria) as a promising alternative for the treatment of antibiotic-resistant infections.

Educating the public: Awareness of the dangers of multidrug resistance is crucial to bring about behavioral changes in the population.