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Antibiotic Resistance:What You Should Know

April 18, 2021, 7:09 p.m. by Dr.Vishwanath Jagannath ( 505 views)

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In our families, we observe the diseases which can be broadly classified into five groups

  1. -Genetic or Hereditary: Diseases which run in the family
  2. -Nutritional disorders: Under Nourished or Over Nourished or Deficiencies
  3. -Infectious Diseases: By Microbes like Bacteria, Virus, Parasites & Fungi
  4. -Neoplasia: Various Cancers
  5. -Others: Like Accidents, Animal bites, Poisons, etc.

This piece will limit its discussion on the importance of judicial use of antibiotics in treating infectious diseases thus preventing antibiotic resistance.

Antibiotics earlier termed as “Magic Bullets” are chemical drugs that kill the germs or microbes without harming the rest of the body. However, over the years it is being seen that the bullets are losing their magic as the germs or microbes have developed bulletproof jackets because of indiscriminate usage.

Infectious Diseases are caused by pathogenic micro organisms such as Bacteria, Viruses, Parasites, or Fungi. These diseases can spread, directly or indirectly from one person to another. There is another class called Zoonotic Diseases, which are infectious in animals that can infect humans. Before the French bacteriologist Louis Pasteur demonstrated the presence of bacteria in the air and advanced the “germ theory of diseases”, there was no clear scientific understanding of the causation of the diseases. This was a major advancement in medicine. There after, Robert Koch showed anthrax was caused by bacteria. Most of you would have read how Ronald Ross discovered malaria being transmitted by mosquito. Thereafter many microbes were discovered as the causative agents of infectious diseases.

The risk of contracting infectious diseases increases exponentially for elderly people, people with comorbid conditions like uncontrolled diabetes, heart diseases, cancer patients (chronic disease conditions), etc., and immunocompromised status where the body immunity levels are low. The terms antimicrobial, antibiotic, and anti-infective encompass a wide variety of pharmaceutical agents that include antibacterial, antifungal, antiviral, and antiparasitic drugs.

Penicillin, the first commercialized antibiotic, was discovered in 1928 by Alexander Fleming. Thereafter, there has been discovery and acknowledgment of resistance alongside the discovery of newer antibiotics. Germs will always look for ways to survive and resist new drugs. Germs are rapidly sharing their resistance, making it harder for us to keep up.

Antibiotics are prescribed for prophylactic usage, like before surgery or dental procedure though now with better infection control measures they are not routinely prescribed. They may be prescribed empirically based on experience without investigations or while awaiting test reports. The ideal way to prescribe them is for definitive therapeutic purposes.

Antibiotic resistance occurs when bacteria change in response to the use of these medicines. Bacteria, not humans or animals, become antibiotic-resistant. These bacteria may infect humans and animals, and the infections they cause are harder to treat than those caused by non-resistant bacteria.

The world urgently needs to change the way it prescribes and uses antibiotics. Even if new medicines are developed, without behavior change, antibiotic resistance will remain a major threat. Behaviour changes must also include actions to reduce the spread of infections through vaccination, hand washing, practicing safer sex, and good food hygiene. Antibiotic resistance is rising to dangerously high levels in all parts of the world. New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases. A growing list of infections – such as pneumonia, tuberculosis, blood poisoning, gonorrhoea, and food-borne diseases, are becoming harder, and sometimes impossible, to treat as antibiotics become less effective. Antibiotic resistance leads to longer hospital stays, higher medical costs, and increased mortality. Any family can be affected by this.

In regions where antibiotics can be bought for human or animal use without a prescription, the emergence and spread of resistance are made worse. Similarly, in countries without standard treatment guidelines, antibiotics are often over-prescribed by health workers and veterinarians and over-used by the public. Without urgent action, we are heading for a post-antibiotic era, in which common infections and minor injuries can once again kill. Antibiotic resistance is accelerated by the misuse and overuse of antibiotics, as well as poor infection prevention and control. Steps can be taken at all levels of society to reduce the impact and limit the spread of resistance.

WHO recommends certain measures to prevent and control the spread of antibiotic resistance, individuals can:

  1. -Only use antibiotics when prescribed by a certified health professional
  2. -Never demand antibiotics if your health worker says you don’t need them
  3. -Always follow your health worker’s advice when using antibiotics
  4. -Never share or use leftover antibiotics
  5. -Prevent infections by regularly washing hands, preparing food hygienically, avoiding close contact with sick people, practicing safer sex, and keeping vaccinations up to date
  6. -Prepare food hygienically, following the WHO Five Keys to Safer Food (keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, use safe water and raw materials) and choose foods that have been produced without the use of antibiotics for growth promotion or disease prevention in healthy animals

In 2015, the Sixty-Eighth World Health Assembly, endorsed the Global Action Plan on Antimicrobial Resistance, calling for a dedicated global campaign to raise public awareness and understanding of antibiotic resistance. World Antibiotic Awareness Week (WAAW) takes place every November to promote global education on antibiotics, how they should be used, and the growing risks of antibiotic resistance.

For more information on Antibiotic Resistance, one can visit

https://www.who.int/en/news-room/fact-sheets/detail/antibiotic-resistance

Reference:

WHO-, Health Topics, Antibiotic resistance

CDC – Antibiotic / Antimicrobial resistance

Parks Text Book Preventive and social medicine 25th edition

 

-Dr.V Jagannath

-He completed MBBS from S.C.B Medical college, Cuttack and Fellowship in HIV medicine from School of Tropical Medicine, Kolkata.

-Served Tata Steel for 15 years, last position held was Head, Centre for Family Initiatives, subsequently joined Jindal Steel and Power ltd as Head ,CSR.

-Thereafter joined Odisha Power Generation Corporation as DGM, CSR and R&R. Presently working with Odisha Coal and Power ltd.

-He can be contacted at vishyjagannath@gmail.com.


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