The latest weapon in the health care system is the use of antibiotics, which, if failed, multiply the patient’s risk of death. Unnecessary use of these antibiotics in our country threatens the patient health safety system.
A review of recently published research suggests that antibiotics have lost their effectiveness against numerous infectious diseases. If this continues, we will see a dire time in the near future when antibiotics will not work against any disease and millions of people will die.
What are antibiotics, and why are health workers concerned about their misuse? Antibiotics are a type of biochemical medicine that destroys bacteria, prevents the proliferation of bacteria, and works against infectious diseases.
Antibiotics lose their effectiveness against infectious diseases when bacteria are able to develop resistance to antibiotics, which in medical terms is called antimicrobial resistance [Antimicrobial Resistance (AMR)].
Antimicrobial resistance is a global problem. Failure to deal with it will lead to a situation worse than the Corona and it is feared that by 2050 the world could lose a million lives.
Antibiotics available in the market are not able to build effective resistance against infectious diseases. Bacteria responsible for infectious diseases are developing resistance to conventional antibiotics due to gene mutations and gene changes.
According to media reports, recently the National Institute of Laboratory Medicine and Referral Center (NILMC) has published partial results of a study on the effectiveness of antibiotics used in infectious diseases by collecting samples of patients of different ages from 12 government hospitals.
Gene mutations and gene changes are known to be observed by sequencing the genome of these samples. Besides, millions of bacterial resistance genes have been identified.
Now the question is what causes bacterial resistance and what is the way to get rid of it? The main cause of bacterial resistance is overuse of antibiotics. Currently, doctors prescribe antibiotics for any common illness (cold, cough, fever, diarrhea, etc.). As a result, frequent use of antibiotics is making bacteria resistant to those antibiotics.
In addition, even though the sale of antibiotics is not allowed in our country, unscrupulous traders are selling them to patients without a prescription. As a result, patients are buying antibiotics without a doctor’s prescription to cure the disease quickly, and if they are about to get better after two or three days, they are giving up the medicine without completing the full course.
This causes the bacteria to weaken but not die. Later they accumulate more energy and develop resistance against that antibiotic. Doctors are often prescribing excessive doses of antibiotics. Negligence of doctors is observed in dosage adjustment.
Antibiotics are also losing effectiveness in testing samples from children recently. In 2022, when my one-and-a-half-year-old child was infected with dengue, I admitted him to a reputed private hospital in Dhaka. The dose of antibiotics the doctor prescribed him was much higher than his weight.
As a conscious parent I asked, he couldn’t give a good answer. In addition, parents are also giving their children antibiotics of their choice to cure the disease faster, which helps the bacteria to develop resistance.
If antibiotics fail to protect patients, the country’s medical system will collapse and the achievement of the Sustainable Development Goals will be impossible. So we all need to prevent the overuse of antibiotics, so as to reduce the incidence of antimicrobial resistance. Here are a few recommendations:
One. Not selling antibiotics without a doctor’s prescription and insisting on completing the course while selling antibiotics.
Two. Pharmacists are experienced in drug dosage adjustment and administration. Hence appointing ‘A’ Grade Pharmacists in hospitals, who can provide proper decision regarding dosage adjustment of antibiotics.
Three. Drug companies should change their drug promotion policies. Strict monitoring should be done to ensure that companies do not market substandard antibiotics.
Four. The organization should be strengthened by appointing necessary manpower in the Directorate of Drug Administration, so that surveillance can be increased in hospitals and retail pharmacies.
No new antibiotic molecules have been discovered in decades, but generations of older molecules are being marketed. So public awareness in the country needs to be increased along with administrative surveillance on the use of antibiotics, otherwise the misuse of antibiotics will increase and face serious health risks.
Dr. A. S. M. Manzoor Al Hossain. Assistant Professor, Department of Pharmaceutical Technology; Elected Member, Academic Council, University of Dhaka
