Antibiotics resistance painful and what should be done to cut losses
Antibiotics: The resistance will make management of pneumonia, malaria, urinary tract infections and chronic illnesses like TB and HIV difficult. PHOTO | FILE
The emergence of bacteria resistance against drugs targeting them is raising global concern among health care workers, governments and policy makers.
According to a WHO 2014 report, resistance to respiratory, urinary tract and blood infection antibiotics has emerged, posing serious threats to managing pneumonia, malaria, urinary tract infections and chronic illnesses like tuberculosis and HIV.
While previously the extent of the problem was thought to be in developing countries mainly, it has become bigger. Increasing patient mobility and more intimate interactions among global citizens, allows resistant bugs to now be carried all over the world.
A year ago social media was awash with talk of a “super bug” that was transmitted through sexual contact that raised concern in North America. The Centre for Disease Control (CDC) data also hints at the concern.
The impact of this problem isn’t just limited to the global health aspects, but also has financial consequences to health systems. The global projected cost of the resistance is in hundreds of billions of dollars and has the potential to escalate.
Antibiotic resistance means multiple drugs have to be used for treatment of one condition and the duration taken for recovery may be prolonged meaning lengthier hospital stays.
On the health angle, common conditions previously salvageable will now progress to severer forms.
Several reasons have been given for this emerging phenomenon, among them the non-adherence to drug prescriptions, treatment guidelines, repeated exposure to substandard medicines and poor pharmacovigilance.
As measures towards arresting this, the WHO recommends that antibiotics be prescribed only when necessary, and if possible for the specific bacteria causing the infection.
In many health setups, however, the crucial laboratory tests needed to identify the offending bacteria are missing. As a result many infections are treated on an empirical basis.
Looking across our labs for capacity to identify pathogen specific infections shows just how lowly we score on that. At best, the average is just two such labs at each of the district level save for big cities and towns which may have more.
Self-medication, the other likely culprit is particularly in vogue in Kenya. In many set-ups purchase of antibiotics over the counter is the norm.
Urinary tract infections and respiratory tract medications are especially routinely purchased over the counter. No wonder these are some of the most affected drugs.
The non-adherence issue is at the health worker’s reach and should be addressed through concerted and sustained education of health workers and the public on the dangers of such behaviour.
Act now
What medics cannot do is ensure the quality and strength of the antibiotics in the market is as required; this is the job of the pharmacovigilance department and they should ensure that regular and sustained evaluation of potency of drugs is done.
Regular checks for developing resistance patterns should also be scaled up by epidemiologists to identify resistance patterns early.
As scheduled drugs, pharmacists should ensure that antibiotics are only dispensed when need exists and not just for the sake of making a sale.
Drug manufacturers and marketers too need to join the fight to support safer and more responsible use of their products by fighting counterfeits. Let’s act before it is too late.
