Emerging Antibiotics Resistance: A wake-up call for action

Have you ever treated a particular disease and was not cured? Are you not surprised why some drugs that you normally use to treat a particular condition no longer works for you when you take them? The diseases you are treating must have developed a defense against such drugs referred to as Drug/Antibiotic resistance. People often ask me how they can tell whether or not they are "resistant" to antibiotics; the answer is that, it is not about humans developing resistance to the drugs/Antibiotics but the Bacteria that causes the diseases

How these bacteria do so is unique. In simple terms, bacteria can develop resistance to an antibiotic by changing it in a way that makes it harmless either by pumping an antibiotic that you have used back outside of the bacteria before it can do any harm or by changing their outer structure so the antibiotic has no way to attach to the bacteria it is designed to kill.

It is worth pointing out that up to half of antibiotics used in humans are unnecessary and inappropriate used.

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The imminent end of the anti-microbial era is a major challenge in public health. Microbes become implicated in various infections and established pathogens reveal new or extended resistance to effective antibiotics thereby making various therapeutic treatments being challenged. However, antimicrobial resistance occurs when microorganisms including bacteria, viruses and parasites change in ways that they render the medications used to cure the infections they cause to be ineffective. Today the number of bacterial strains that are resistant to one or more antibiotics is multiplying at an alarming rate.

According to the Centre for Diseases Control, an estimated 2 million people a year develop infections as a result of hospital care and of those, 70% are resistant to at least one of the antibiotics most commonly used to treat them

This is a major concern as resistance to antimicrobials can kill; cause infections to spread to others and ultimately impose huge health care bills to individuals and the society.

Antibiotics resistance: How it started

Antibiotic is probably the most important advances in human health alleviating suffering from diseases and saving billions of lives in the past 70 years since discovery of penicillin. Antimicrobial includes antibiotics, antifungal, chemotherapeutic agents and antiviral medicines. Alexander Fleming (a Scottish physician), in 1943 discovered that penicillin was becoming universally available and totally depended on for healing especially during the era of infected wounds (the biggest killer of US soldiers in World War II). Few years later, strains of bacteria that is capable of defending themselves against penicillin was discovered. Since then, scientists has continued to develop series of different and more powerful antibiotics, but these bacteria keep developing strains which have resistance to these drugs.

Causes of Antimicrobial Resistance

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Microbial resistance is caused by inappropriate use of sub-standard dose; not finishing a prescribed dose; low quality medicine and wrong prescriptions including poor infectious in our environment. 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 foodborne diseases – are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.

Recently, the problem of antimicrobial resistance has been attributed to be common in Asia and African continents. Research showed that about 4.15 million deaths will be attributed to Antimicrobial Resistance in Africa by 2050, second only to that of Asia. In Nigeria, the increasing trend of antimicrobial resistance will constitute an impediment to achieving the goal of national health policy and ultimately undermining sustainable health for Nigerians.

1. Overuse

Antibiotic overuse is one reason why many antibiotics develop resistance. People take 235 million doses of antibiotics every year. The Centers for Disease Control and Prevention estimates that one third to one half of that use is unnecessary.

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Overuse includes taking antibiotics for colds or other viral infections, chronic antibiotic use to prevent infections, and use of antibiotics for minor conditions that will resolve on their own. Doctors often report feeling pressured by worried patients to prescribe antibiotics. It is easier to write a prescription than to take the time to explain why an antibiotic isn't needed, especially in these days of managed care when health care providers are being forced to spend less time in each patient contact.

Health care providers may also not be certain whether an infection is bacterial or viral. Laboratory tests to identify the cause of the infection require extra time, additional expense and often an extra office visit. A situation where anybody can buy antibiotics without prescription from any chemist will increase the occurrences of antimicrobial resistance. In Nigeria, drugs can be purchased from any patent medicine vendor provided it was prescribed by a medical doctor. But approaching public transport buses, street vendors, or unapproved patent medicine shops who hawk adulterated antimicrobial agents is an eyesore.

2. Misuse

It is essential for us to be aware that when bacteria are not exposed to an appropriate and sufficient dose of antibiotics, they develop stronger resistance. One of the easiest way that antibiotics are misused is when you stop taking your antibiotics after feeling better but have not completed the full dose.

3. Agricultural usage

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Another important way in which in which antibiotics develop resistance is through their usage in agriculture. Nowadays, antibiotics are added as a supplement to animal feeds. The addition of low levels of antibiotics to animal feed caused animals to gain weight faster and thus get to market faster. When such animsls were eaten, apart from the likely occurrence of food poisoning, the resistant of such antibiotic can develop.

For example, Samonella and Campylobacter is now becoming resistant to an important class of human antibiotics that was recently approved for use in poultry

4. Others

As many antibiotics resistance are emerging everyday, new sources are also emerging. Recently, antibiotics resistance in humans has been suspected to develop as a result of it's discharge in large quantities into the environment during pharmaceutical manufacturing through inadequate wastewater treatment. Likewise, antibacterials in soaps and other products have also been suspected to contribute to antibiotic resistance.

Mitigating Antimicrobial Resistance

Everyone is a stakeholder in preventing antimicrobial resistance. These include the general public, patients, health care providers, hospital administrators, pharmacists and patent medicine vendors. In reducing antimicrobial resistance, the public need to be educated to see medical practitioners for right prescriptions against microbials.

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All prescriptions of antimicrobials should be completed and people should not stop their course of prescriptions as soon as they feel better. There is need for the practice of good infection control everywhere at all times.

Avoid using antimicrobial antibacterial scrubs except when necessary as this can contribute to developing resistance streams. Plain soap and water is good enough. Wash your hand particularly before food preparation and using the toilet. The enforcement of laws such as that chemists only dispense drugs to buyers on submission of prescriptions from medical practitioners will equally enhance misuse of antimicrobials and reduce antimicrobial resistance. The activities of government agencies like National Agency for Food and Drug Administration Control (NAFDAC) will help Nigerians by safeguarding their health against fake and adulterated drugs.

Conclusion

Let me conclude by supplying this piece of advice. At all times, always follow the WHO 5 Keys to Safer Food: keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, use safe water and raw materials. However, good infection control in health care settings, proper hygiene andsanitation should be effectively observed.

Please consult your Medical Physician for guidance on all health related issues

All Images Used In This Article, Are Linked To The Respective Owners

Thank you for reading

|References|

Akinde OS, Taiwo MO (2017) Emerging Antibiotic Resistance in Africa, Threat to Healthcare Delivery. MOJ Biol Med 1(4): 00023. DOI: 10.15406/mojbm.2017.01.00023

National Research Council, Committee on Drug Use in Food Animals (1999). The use of drugs in food animals: benefits and risks. Washington (DC): National Academy Press.

Center for Disease Control (2015) Antibiotics Aren’t Always the Answer

Microbe online: Antibiotic Resistance: Origin, Causes, Mechanism and Prevention

Natural choice: Antibiotics

Wikipedia: Antimicrobial resistance

World Health Organisation (2015): Antibiotics resistance

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