Say no to antibiotics and protect our future!
Antibiotics are substances that act on bacteria by either suppressing or killing them. They are also known as antimicrobials. The first antibiotic penicillin was discovered by Sir Alexander Fleming in 1927 though antibiotics against infectious agents were only introduced during World War II. Antibiotics have been helpful in saving thousands of lives. The incidence of many infectious diseases such as meningitis, tuberculosis and pneumonia declined with the introduction of Penicillins and other groups of antibiotics which were introduced subsequently. However, bacteria have acquired resistance to antibiotics in the present day, making it difficult to combat them as easily as before.
Antimicrobial resistance among bacteria has been demonstrated even before the discovery of antibiotics by Fleming, but with the introduction of antibiotics, bacteria have acquired resistance more rapidly than ever before. Bacteria find ways to survive in adverse conditions through various means. Even though they are unicellular, they seem to be more intelligent than human beings when it comes to how they acquire resistance, adapting and surviving despite ever increasing advances in the medical field. Resistance mechanisms have been described for all known antibiotics currently available for clinical use.
Today, antibiotic resistance has become a major threat to human beings. The prevalence of multi-drug resistant microorganisms both in hospitals and the community is increasing worldwide. The problem is greater in developing countries such as Sri Lanka due to uncontrolled use of antibiotics. As per the latest release from the Center for Disease Control (CDC) in Atlanta (USA),dated September 16, 2013, it is recorded that at least 2 million Americans fall ill from antimicrobial-resistant bacteria every year and that at least 23,000 die from these infections. It is noteworthy that the federal authority has quantified the effects of antimicrobial resistance for the first time, which highlights the powerlessness of antibiotics against infectious agents.
One particularly lethal type of drug-resistant bacteria, known as CRE (carbapenem resistant Enterobacteriacea) has become resistant to nearly all antimicrobials on the market. It is found in our hospitalised patients as well due to uncontrollable use of these antibiotics.Another problematic bacteria called MRSA (Methicillin resistant Staphylococcus aureus) is often found in community acquired infections.
Overuse and misuse of these precious medicines will soon drive us back to the pre-antibiotic era where thousands of patients died due to lack of antibiotics. A crisis has been building up over decades and today, common yet life-threatening infections are becoming difficult, or even impossible, to treat. It is time to take much stronger action worldwide to avert this ever-increasing health and economic burden.
While infectious agents are becoming more and more resistant to the antibiotics that are currently in use, not enough drugs are being developed to combat them. Over the years the number of new antibiotics coming to the market has decreased gradually. To develop a new antibiotic, a pharmaceutical company has to spend around 700 million to one billion US dollars but most often they do not get adequate returns for their investment. Therefore companies are reluctant to invest their money on antibiotics. Due to this there are only a few antibiotics in the pipeline for the next five years or so.
We too promote antibiotic resistance in bacteria by various means. Many people in our country treat themselves by taking antibiotics without a doctor’s prescription. Pharmacy owners provide antibiotics on request, ignoring the laws and regulations that govern the pharmaceutical profession. Many pharmacies in our country are manned by unqualified people who sometimes prescribe antibiotics to patients without the proper knowledge, expertise and qualifications to do so. People go to pharmacies and speak of their ailments to these unqualified, so-called pharmacists who issue drugs and get their antibiotics. Even qualified pharmacists are not trained to prescribe drugs.
After going to a doctor some patients do not take antibiotics according to the prescription or stop taking them without finishing the full course. When you take antibiotics, make sure that you follow directions from your doctor carefully. It is important to finish your antibiotics even if you feel better. If you stop treatment prematurely some bacteria may survive and re-infect you, and the same antibiotics may not work the second time as the bacteria have developed resistance. You have given them the chance to find a way to evade the action of antibiotics.
Antibiotics do not act on viruses. Therefore they are of no use in diseases such as common cold, mild sore throat and viral diarrhoea. Taking antibiotics for viral infections may do more harm than good. Each time you take antibiotics, you increase the chances that bacteria in your body develop resistance to them. Later, you could get an infection that those antibiotics cannot cure. You and your loved ones can lose lives for treatable illnesses like pneumonia and urinary tract infections due to lack of effective antibiotics.
What is more concerning perhaps is that doctors themselves are prescribing antibiotics unnecessarily and misusing them very often. They use strong antibiotics when a simple antibiotic like penicillin could be effective against certain diseases. Some use systemically used antibiotics for dressing of wounds which is a very wrong practice. Antibiotic resistance has become one of the major problems in our hospital settings. About half of antibiotic use in people is inappropriate.
Even though it is quite late in the process, at least now Sri Lankan Health Ministry officials should take strong action regarding this matter and regulate the use of antibiotics by doctors. An antibiotic policy together with a stewardship programme needs to be implemented urgently as we are heading for a disaster in the near future. Patients should be encouraged to ask their doctors about antibiotics that they receive.
Another reason for antibiotic resistance is the use of antibiotics in agriculture, fisheries and veterinary practice. Industrial-scale animal farming contributes to the problem of antibiotic-resistant infections in humans. People use many antibiotics as growth promoters in animals and fish farming. It was estimated that more than 70 per cent of antibiotics in the United States are given to animals. Similarly our farmers and veterinarians are using antibiotics in an uncontrolled manner. Much of antibiotic use in animals is unnecessary and inappropriate. Health Ministry officials together with agriculture, fisheries and veterinary ministry official should develop regulations to minimise the use of antibiotics in these industries.
Do we want to step towards the pre-antibiotic era where thousands of people died of infectious diseases due to lack of antibiotics? Do we expect our children and their children to die due to lack of effective antibiotics? It is the responsibility of all of us to protect our future generations from this disaster. The rulers and administrators, especially Health Ministry officials and doctors have a major role to play in this regard.
Save these precious molecules and use them wisely to protect our children and our nation.
(The writer is a retired Microbiologist)
comments powered by Disqus