Use antibiotics well to preserve gains, avert crisis

The world antimicrobial awareness week, marked every third week of November, provides an opportunity to reflect on our journey in antibiotic usage, the gains and losses occasioned by rising antimicrobial resistance.

In a statement made in 2014, Dr Margaret Chan, Director-General WHO 2006-2017, said ‘’Antimicrobial resistance threatens the very core of modern medicine and the sustainability of an effective, global public health response to the enduring threat from infectious diseases”

Up until their discovery, bacterial infections resulted in tragic consequences such as prolonged illness, complicated course, debilitation and death. This was largely reversed with the discovery and use of penicillin.

However, over time bacteria started fighting off or resisting the effect of antibiotics and encode these characteristics into their DNA to ensure transfer to future generations of bacteria, this is antimicrobial resistance (AMR).

As ominously predicted by Sir Alexander Fleming in his Nobel Prize acceptance speech in 1945 ‘’The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily under-dose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.’’

This has largely come to pass with striking resemblance to the prediction.

The key drivers of AMR include antibiotic misuse, poor quality drugs, unregulated use in animal husbandry, poor diagnostic capability and inadequate infection prevention.

These developments have been observed clinically as difficult to treat infections, higher antibiotic dosage requirements, lost protection in prophylaxis as well as a higher death rate from previously treatable infections, gradually reversing gains.

In 2014, the WHO brought this matter to the attention of global stakeholders to discuss impact and mitigations against the development of AMR. The result was five action points Global action plan on antimicrobial resistance namely, raising awareness, improving knowledge through surveillance and research, reduction in infection, optimisation of antibiotic usage and sustainable investment in new drugs, diagnostic tools and vaccines.

GlaxoSmithKline has driven initiatives across all the WHO recommended areas of action, to mitigate against the rising risk of AMR such as, public awareness and surveillance of antimicrobial resistance.

GSK has also driven capability programmes on appropriate antibiotic usage for clinicians respective to various disease states requiring antibiotics, pipeline investment in new antibiotics and vaccine development and distribution to prevent infections and reduce disease severity.

Controlling availability, access and utilisation of antibiotics in Kenya, enhancement of clinical competence and diagnostic capability, and educating the public on responsible usage of antibiotics are focus areas.

Let everyone preserve the effectiveness of available antibiotics to protect the future of humanity.