Dear Editor,
Antibiotics provide some of the best examples of progress in modern medicine. Many infections that were once considered incurable and fatal can now be effectively treated with antibiotics. However, the rapid development of antibiotic resistance threatens the effectiveness of antibiotics. According to the latest figures, the number of deaths due to antibiotic resistance is about 700,000 worldwide. Then, by 2050, deaths related to antibiotic resistance are projected to increase to 10 million per year.
Much attention has been paid to eliminating the misuse of antibiotics to slow the progression of resistance. However, antibiotics are misused in many ways, including using them in patients who do not appear to have a bacterial infection, using them for an unnecessary amount of time, and using multiple doses or broad-spectrum agents when they are not needed. A large number of antibiotics have been used in agriculture & poultry to stimulate growth and prevent infection in livestock, contributing to the selective pressure that makes organisms resistant.
According to the guidelines of the World Health Organization (WHO), antibiotics are used rationally for the relevant indications, in doses tailored to the specific needs of the patient, for an acceptable period of time, with appropriate information. If any of these parameters are not achieved, it leads to irrational or unnecessary use of drugs.
A recent global study conducted in 76 countries reported that the irrational use of antibiotics is escalating, both in developed and developing countries. It is estimated that around 80% of antibiotics are used in the community, where buying antibiotics without a prescription is very common, especially in low- and middle-income countries, where policies and regulations are already in place. People in these countries have lack of knowledge and seek immediate help, to which doctors respond by giving antibiotics in the hope of a speedy recovery. This ultimately leads to higher health care costs, longer hospital stays, and immediate or long-term health consequences, including significant increases in morbidity and mortality.
Additionally, during the Covid-19 pandemic, there has been an unprecedented increase in the consumption of antibiotics as people were infected with mild to moderate symptoms – cough, fever and lung infiltration similar to bacterial pneumonia – and doctors had little choice but to prescribe antibiotics. Because a gray line exists between bacterial pneumonia and COVID-19.
Antibacterial resistance is now a global scourge that demands collective and broad-collaborative efforts for prevention. To prevent this crisis, over-the-counter access to antibiotics in pharmaceuticals must be tightly controlled through improved stewardship and surveillance. Dispensers of antibiotics should be well educated and aware of the consequences of dispensing antibiotics irrationally.
Economic incentives that encourage the overuse of antibiotics in society must be removed. Moreover, periodic education campaigns have to be organized to educate and prevent the overuse of antibiotics in the local community, emphasizing the fact that antibiotics play no role in the treatment of common colds, sinus infections, and acute diarrhea, as they are usually caused by viruses.
The antibiotic supply chain should also be strictly controlled and monitored. National surveillance should be ongoing to monitor antibiotic susceptibility and resistance, with results disseminated to policy makers and the community to garner financial and political support for improved antibiotic use.
Sincerely,
Dr. Jagan Nadipelly
Assistant Dean and
Associate Professor
of Pharmacology
College of Medicine,
Texila American
University
