... Antibiotic resistance can develop naturally, through mutations or gene transfer. 1.1 Natural resistance Resistance to antibiotics may be acquired naturally as in the case of some 2000 years old bacteria found in an arctic glacier which are naturally resistant against some antibiotics (Bren 2002). 1.2 Chance mutations Spontaneous DNA mutations which change bacterial genetic material also enable bacteria to inactivate antibiotics (HPA 1999). This occurs about 1 in 1 million to 10 million cells. 1.3 Gene transfer Bacteria can exchange resistance genes (Figure 2) with bacteria of other species through the movement of plasmids or transposons (Lewis 1995). Drug-resistant tuberculosis arises this way. Figure 2: Transfer of plasmid between bacteria 2.0 Factors causing antibiotic resistance Factors causing antibiotic resistance include indiscriminate use of antibiotics, misdiagnosis and spread of counterfeit drugs. 2.1 Indiscriminate use of antibiotics The primary contributor of antibiotic resistance is the misuse of antibiotics. Although antibiotics only work ...

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