Beginning with the discovery of penicillin by Alexander Fleming in the late 1920s, antibiotics have revolutionized the field of medicine. Antibiotics not only have saved millions of lives each year these also alleviated pain and suffering and have even been used prophylactically for the prevention of infectious diseases. Bacterial infections have plagued humans throughout history. In the past 70 years, antibiotics have changed the world by saving and improving countless lives, establishing them as the cornerstones of all modern health systems. However, we have now reached a crisis where many antibiotics are no longer effective even against the simple infections. Although antibiotics save millions of lives, but the excessive usage make them less effective and sooner or later, the bacteria evolve against the antibiotics being used. What is at stake here? Without finding the solution to combat antibiotic resistance, the care we take for granted today like surgery chemotherapy and dialysis may become too dangerous and simple infections too may become deadly. We are all at risk. As early as 1945, Sir Alexander Fleming himself raised the alarm regarding antibiotic overuse when he warned that the "public will demand [the drug and] ... then will begin an era ... of abuses."
What exactly is antibiotic resistance? It is the ability of a microorganism, e.g., bacteria, to stop an antibiotic from working against it. As a result, standard treatments become ineffective, infections persist and may spread to others. Antibiotic resistance has the potential to affect people at any stage of life, as well as the healthcare, veterinary, and agriculture industries, making it one of the world's most urgent public health problems. This havoc is now considered a major health crisis in almost all countries of the world, including Pakistan, resulting in a frightening increase in the burden of infections due to multi-drug resistant organisms while limiting the choice of antibiotics for treatment. A growing list of infections - such as pneumonia, tuberculosis, gonorrhoea, diarrhoea and other food-borne diseases - are becoming harder, and sometimes impossible, to treat as antibiotics become less effective. In countries such as Pakistan where antibiotics can be bought for human or animal use without a prescription, the emergence and spread of resistance is made worse. Similarly, in countries without standard treatment guidelines, antibiotics are often over-prescribed by health workers and veterinarians and overused by the public.
Now the question is: what impact this problem can have on our daily lives? When infections can no longer be treated by first-line antibiotics, more expensive medicines must be used. A longer duration of illness and treatment, often in hospitals, increases healthcare costs as well as the financial burden on families and societies. Not only this but increased side-effects from the use of multiple and more powerful medications. Simple operations, chemotherapy and surgeries such as caesarean sections become much more dangerous without effective antibiotics for the prevention and treatment of infections leading to increase morbidity and mortality.
Tackling antibiotic resistance is a high priority for World Health Organisation (WHO). A global action plan on antibiotic resistance was approved at the World Health Assembly in May 2015. Unfortunately, antibiotic resistance cannot be fixed by easy technical interventions and the issue must be addressed at all levels of society. Steps can be taken to reduce the impact and limit the spread of resistance against antibiotic. To prevent and control the spread of antibiotic resistance, policymakers can ensure a vigorous national action plan. Policies should be made and implemented to take strict measures against easy access and irrational use of antibiotics. There should be improved surveillance of antibiotic-resistant infections. Greater efforts should be made at the government level for infection prevention and its control. There is a strong need to make information available on the impact of antibiotic resistance among the masses and for this purpose both electronic and social media should be used.
In this regard, health professionals should also play their part by prescribing and dispensing antibiotics when they are needed. They should educate the patients about how to take antibiotics correctly, antibiotic resistance and the dangers of misuse. But the most important role should be played by individuals. The important aspect in dealing with this issue is that a person should only use antibiotics when prescribed by a certified health professional. Patient should never demand antibiotics if the doctor says that they don't need them and if prescribed patients should finish the entire antibiotic course. Individuals should never share or use leftover antibiotics. And culture of self-medication should also be discouraged.
The world urgently needs to change the way it prescribes and uses antibiotics. Even if new medicines are developed, without behaviour change, antibiotic resistance will remain a major threat. Unfortunately, inappropriate and excessive use of antibiotics is common in both high- and low-income countries. While legal regulation of antibiotic sales has worked in various parts of the world, in other places such restrictions are difficult to implement in practice. That being said, enforcing regulation of inappropriate use could have a direct impact on preserving the effectiveness of these life-saving medicines. Nevertheless, it is encouraging to note that the government of Pakistan has already embarked upon a national action plan for addressing the issue of anti-microbial resistance, in order to sensitize all the stakeholders- the producers, the retailers, the prescribers, and most importantly the end users.
(The writer is Associate Professor Pharmacology)
Comments
Comments are closed.