Overuse Of Antibiotics- A Growing Public Health Threat

Off late, the battle between bugs and drugs is being immensely talked about. And why not? Antibiotic resistance is growing rampantly and seems to be in the race for the next international pandemic.

Antibiotics that have treated and saved countless lives for over sixty years are now the very cause for more deadly illnesses to strike. According to a harsh warning issued by European experts, routine clinical procedures would soon become very difficult to treat due to shortage of effective infection fighting drugs.

Antibiotics are known to kill bacteria that cause infections. Then again, bacteria multiply very fast and for that reason, when antibiotics are used excessively, bacteria adapt and develop newer strains that are resistant to drugs.  Another predominant feature with bacteria is their ability to swap their genes under certain conditions. This allows drug resistant bacteria to share their resistance mechanisms with their kin, thus developing more and more strains of drug-immune bacteria.

This has today given rise to a situation wherein lack of adequate research for developing more potent antibiotics are leaving healthcare practitioners with no alternatives to treat even common infections, that fail to respond to existing line of antibiotic treatment. Moreover, emergence of “superbugs” such as methicillin-resistant staphylococcus aureus (MRSA) is causing the growing problem of hospital-acquired infections. 71% of staph infections are MRSA in nursing homes.

Dr Kathleen Holloway of the World Health Organization (WHO) says, “Antibiotic resistance is a global problem, with diseases including childhood pneumonia, dysentery and tuberculosis (TB) no longer responding to first-line antibiotics in some parts of the world.  We’ve got to a situation where there are no more drugs for certain conditions. There are some people with extreme drug-resistant TB and there are no drugs to treat them”.

GP’s are being put under pressure to limit the prescription of antibiotics, unless absolutely necessary. In the UK, Department of Health launched a major advertising campaign to educate and emphasise on the fact that minor, self-limiting viral infections — including most coughs and colds — do not respond to antibiotics. Doctors have also been given a new guidance suggesting that antibiotics should no longer be used routinely in other upper respiratory conditions such as sinusitis and tonsillitis. Having said that, it is also important to point out that 38 million prescriptions for antibiotics were given out last year, greatly also due to patient insistence. According to Dr. Laurance Buckman of the British Medical Association, doctors are fearful of getting into arguments with their patients. But Dr. Mark Potter says, “It is going to take a significant change in behaviour on both sides of the surgery desk if we are to change prescribing habits of doctors and make a difference.”

Currently, antibiotics are not used for more than ten to fourteen days, while patients with chronic diseases like diabetes or heart disease use medications for their entire lifespan. This is one of the main deterrents for pharmaceutical companies to expend R & D efforts on developing new antibiotics. Researchers therefore feel that governments need to pump in incentives, like developing an international fund, for pharmaceutical companies and urge them to invest time in developing newer antibiotics.

Says Dominic Monnet of the European Centre of Disease Prevention and Control: “If this wave of antibiotic resistance gets over us, we will not be able to do organ transplants, hip replacements, cancer chemotherapy, intensive care and neonatal care for premature babies. We could lose the whole span of modern medicine as we know it”.

As consumers and patients, we too need to contribute to this effort being put in to reduce antibiotic resistance by not insisting on an unwarranted script for medicine that can do more harm than good.

Article by Snigdha Taduri for Biomed-ME