Prudent use of antibiotics stressed

LAHORE:New antibiotic resistance mechanisms threaten our ability to treat common bacterial infections and, without urgent action, we are heading for a post-antibiotic era, in which common infections and minor injuries could once again be fatal.

The infections are caused by microorganisms such as bacteria, fungi, viruses and protozoan parasites. Medicines that are used to treat infections are called antimicrobials.“The widespread use of antimicrobials has been linked to microbes changing and becoming resistant to treatment. This means that the antimicrobials we have available no longer stop all microbes causing the infection. Some survive to cause long lasting and severe infections, known as antimicrobial resistance (AMR),” said Dr Summiya Nizamuddin, Consultant Medical Microbiologist, while talking to The News.

The World Antimicrobial Awareness Week (WAAW), being observed from November 18-24, 2022 endorsed by WHO, is a global campaign that is observed annually to improve awareness and understanding of AMR and encourage best practices amongst the public, health stakeholders and policymakers, who all play a critical role in reducing further emergence and spread of AMR. This year, the theme of WAAW is “Preventing Antimicrobial Resistance Together”, whereby all sectors are encouraged for the prudent use of antimicrobials and to strengthen preventive measures addressing AMR.

These medicines, otherwise, play an important role in fighting infections in people who may be at a higher risk of getting an infection, such as those having surgery or receiving cancer treatment.

The WHO describes AMR as one of the biggest threats to global public health, stating that ‘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’.

In 2019, researchers estimated that AMR in bacteria caused an estimated 1.27 million deaths. Another report warned that AMR could lead to 10 million deaths each year by 2050. A global action plan to tackle the growing problem of resistance to antibiotics and other antimicrobial medicines was endorsed at the sixty-eighth World Health Assembly in May 2015. One of the key objectives of the plan is to improve awareness and understanding of AMR through effective communication, education and training.

Dr Summiya Nizamuddin, who is serving at Shaukat Khanum Memorial Cancer Hospital and Research Centres (SKMCH&RC), said that the threat of AMR in developing countries, such as Pakistan, where a large proportion of the population has limited access to education and healthcare, is significant.

In common with the rest of the world, there has been a reported upsurge in infections due to resistant strains in Pakistan. For example, a 2019 WHO report ranked Pakistan amongst the top five countries with the highest number of neonatal deaths caused by resistant bacteria.

“Pakistan is also the third-highest antibiotic-consuming country among low- and middle-income countries (LMICs),” she revealed.

Lack of some, or all, of the following factors further worsen the current situation of AMR in the country: access to appropriate antimicrobial therapy; regulation of antibiotic use in humans, agriculture and livestock; surveillance of antibiotic use and resistance; updated antibiotic use and treatment guidelines; continuing medical education on antibiotic use for prescribers; microbiological laboratory capacity and training; and diagnostic tools. Increasing AMR further complicates the management of treatable infectious diseases such as malaria, tuberculosis, acute RTIs, and diarrhoeal diseases.

Dr Summiya says there is a desperate need for coordinated action, if the prevailing AMR situation needs to be curtailed. “There are various steps that can be taken at all levels of society to reduce the impact and limit the spread of resistance.