Antibiotic resistance emerges as one of the biggest health problems

Rawalpindi
The antibiotic resistance has emerged as one of the biggest health problems, the world is facing. In Pakistan, the problem is more severe in nature being associated with a number of other health threats mainly due to quackery and increasing practice of self-medication.
Easy availability of antibiotics over the counter without doctor’s prescription in Pakistan has been promoting self-medication that is resulting in overuse and misuse of antibiotics increasing the development of resistant bacteria.
According to estimates, there are more than 6,00,000 quacks operating across the country. Quacks prescribe and administer heavy antibiotics and steroids for quick results and a fast buck. This practice in addition to development of antibiotic resistance also damages liver, kidneys and testes.
Head of Community Medicine at CMH Lahore Medical College Professor Dr Muhammad Ashraf Chaudhry expressed this while talking to ‘The News’ on Monday in connection with the first World Antibiotic Awareness Week launched by World Health Organisation from November 16 to 22.
Recently WHO has launched a global campaign, ‘Antibiotics: Handle with care’, during the first week. The aim of the campaign was to raise awareness and encourage best practices, among the public, policymakers, health, and agricultural professionals to avoid the further emergence and spread of antibiotic resistance.
Among the reasons identified by the WHO are: widespread misunderstandings about the problem and causes, including the abandonment of treatment halfway, the ease with which antibiotics are available without prescription in many countries, and their indiscriminate use.
Antibiotic resistance that is a serious issue globally happens when bacteria change and become resistant to the antibiotics used to treat the infections they cause.
It is ironical that antibiotics are also prescribed for treating colds and flu by unqualified practitioners, despite the fact that antibiotics have no effect on the viruses, said Dr. Ashraf. He added majority of people stop antibiotics when they feel better, rather than completing the prescribed course of treatment and it certainly causes resistance.
He said in Pakistan, the antibiotic prescription in cases pertaining to children between one year and 15 years of age may be as high as 89 per cent and their prevalent use has made antibiotics almost ineffective against the infections they are manufactured for.
He, like many other health experts, is of the view that resistance to antibiotics has reached dangerous levels globally and also in Pakistan and if left unchecked, this will mean the end of modern medicine as we know it. It means humanity is hurtling towards a post-antibiotic era in which common infections may start killing people once again, he said.
Professor Ashraf said the rise of antibiotic resistance is a global health crisis, and governments should now recognise it as one of the greatest challenges for public health. Antibiotic resistance is compromising our ability to treat infectious diseases and undermining many advances in medicine, he added.
To a query, he said the antibiotic resistance spreads to the general public in two ways. One when antibiotics are given to patients, which can result in drug resistant bacteria developing in the gut. Patients attend hospitals or clinics and spreads drug-resistant bacteria to other patients through poor hygiene and unclean facilities. The other way is that antibiotics are given to food producing animals and crops. Animals develop drug resistant bacteria in their gut. Drug-resistant bacteria reach humans through food, the environment including water, soil and air or by direct human-animal contact.
He warns that the issue needs to be highlighted at a higher level to save the people from an unending vicious circle of infectious diseases as the re-emergence of infectious diseases era has started. “As a public health professional, I urge policymakers to formulate sound policies on antibiotic prescription, and over the counter sale and save the people of Pakistan from a time when no antibiotic would be able to cure infections.”
Talking of a short-term practical approach to prevent antibiotic resistance especially in countries like Pakistan, he said that only qualified doctors should be authorised to prescribe antibiotics and only when it is necessary and in condition when infection fails to heal to its own.
“Moreover, it should be ensured that antibiotics to animals including food producing and companion animals are only used to control or treat infectious diseases and under veterinary supervision.”
He added general public should be educated through media to use antibiotics when prescribed by certified health professional. Always take the full prescription, even if you feel better. Never use leftover antibiotics. Never share antibiotics with others. Prevent infections by regularly washing your hands, avoiding contact with sick people and keeping your vaccinations up to date, he suggested.
Health workers can also play part in preventing infections by ensuring that their hands, instruments and environment are clean. Keep your patient’s vaccinations up to date. If you think patient might need antibiotics, where possible, test to confirm and find out which one. Only prescribe and dispense antibiotics when they are truly needed. Prescribe and dispense the right antibiotic at the right dose for the right duration, concluded Dr. Ashraf.