Genesis of Antibiotic Resistance LXII: Mitigation of Antibiotic Resistant Bacterial Pathogen(s) (ARBP) / Clinical Persisters (cPrs) (ARBP - cPrs) herded Pandemic by Effective Preventive Measures

ABSTRACT

An inspiration for an analysis of plausible of Pandemic impelled by Antibiotic Resistant (AR) infectious diseases (PARID) was derived from the observations during Covid-19 pandemic from February 2020 on till the time of submission of this work and also from a colloquium on the role of multiple socioeconomic factors impinging on pathophysiological factors (lymphatic system functions) contributing for the plausible sixth mass extinction. We have formulated three prong approach namely, (focusing on reducing the antibiotic footprint, drug resistance index - resistance map DRI-RM, implementation of antibiotic stewardship) I Prevention, II Treatment (Clinical care), and III Rehabilitation of cohort with or without comorbidity. Here, we present a multitude of mitigation strategies as a part of I Prevention Non-Pharm. Intervention i. establishment of internet site/home page for issuing and monitoring a national alert for lockdown /followed by a 48 ? 72-hour mandatory preparatory process for stay home / shelter-in order simultaneous call center for guidelines and concerted effort in undertaking the contact tracing of the infected person sustaining quarantine / social isolation, ii. hand washing for 20 seconds before and after work, preparing food, dining, sneezing, coughing, iii. avoid crowds / close contact with sick people, iv. avoid community gathering (not more than 5, no cinemas, conferences, beauty salons), v drink adequate amount of water, vi Wear personal protection equipment while maintaining six feet during the rationing or going to the groceries hospitals or other life demanding event activities then demands demanding activities and see being informed by the local city states national global morbidity and mortality data on a daily basis, vii disinfect the surface of frequent contacts (door knob, toilet seat, dining table, electronic devices namely phone, computers, tv remotes, viii Avoid shaking hands, ix Stay home while taking a short walk in the lawn maintaining 6 feet distance with other person, x Decontaminate arriving from work or unknowingly touching an infected/sick patient by taking shower, washing clothes, xi Avoid touching your face, xii Avoid non-essential travels including the hot zones from where the disease started spreading, xiii Isolate the Footwear before entering the house, xiv No personal handkerchief, xv Decontaminate the personal jewelries, xvi Preferably vegetarian food, if not well cooked meat diet, and xvii Avoid unnecessary trips domestic / aboard / cruses) and well-coordinated pause in stay-home/shelter-in laws. Prophyl. Meas DDX of the clinically recorded signs and symptoms of infectious diseases, plasma therapy, medically supervised implementation of vaccine campaigns as needed, stock pile of vaccines at each health care centers. Taken together, effective implementation of aforesaid mitigation measures, PARID would be improbable to impart a vile mortality rate. However, the plausibility of a higher morbidity rate of asymptomatic carrier with an array of comorbidity requiring concerted integrative approach for rehabilitation.