An antibiotic is simply a name given to a large group of diverse chemical agents that are usually produced in nature by microorganisms capable to negatively affect the growth and even destroy other microorganisms. These are used mainly as treatment against infectious diseases and as a method to avoid contamination of sterile environments.
When we talk about antibiotic or antimicrobial resistance, we refer to a particular phenomenon characterized by a change in the microorganism. This change causes the drugs to be rendered ineffective, meaning, the germs are no longer being killed and their growth is not severely affected.
This phenomenon is common in bacterial, viral and parasitic infections and make them much more difficult and expensive to treat, forcing doctors to consider even toxic alternatives as treatments.
In this article we will use bacterial infections as our main example, however, not only bacteria can become quickly resistant to antibiotics.
Over the Counter Antibiotics
Over the counter antibiotics (OTCA), can be easily purchased without any license or prescription in Pakistan. OTCA represents from 19% to 100% of antibiotics used by regular individuals worldwide.
There are a few problems with heavy use of OTCA by the population, mainly:
Misapplication (incorrect/inappropriate use for non-bacterial diseases)
Severe drug reactions
Masking of underlying infectious diseases.
However, one of the most important negative effects is antibiotic resistance, which has lead to a worldwide crisis.
The antibiotic resistance crisis is increasing due to the overuse of antibiotics. Bacteria and several other microorganisms have unique biological mechanisms that allows populations to adapt very quickly to new toxic agents. This implies that if a bacterial population is exposed to an antibiotic and it’s not killed entirely, then, the remaining bacteria can start growing into a new antibiotic-resistant population. Incorrect use or overuse of OTCA by a human population severely increases the chance for dangerous bacterial populations to arise. This has been happening around the world at a frightening speed.
Antibiotic Resistance in Pakistan
Pakistan healthcare infrastructure is currently not adequate to deal with the resistance crisis. There is an indiscriminate use of antibiotics and the public is not aware about the dangers. Right now, bacterial antibiotic resistance is rising dramatically, to the point in which new “superbugs” have become a true risk for the general population. Such is the case of NDM-1.
Bacterial infections with positive identification of NDM-1 (New Delhi metallo-beta-lactamase enzyme) are extraordinarily difficult to treat. It’s because these Bacteria are becoming resistant to all known antibiotics currently being used for clinical treatment. Many other infections are becoming as aggressive as this, leaving Pakistan near a crisis of several simultaneous epidemics of multi-drug resistant bacteria.
Other microorganisms known to be rising as antibiotic-resistant populations are: Acinetobacter baumannii and Salmonellae.
Prevention: Avoidance of infections by widespread immunization, safe food preparation, handwashing and only using antibiotics under medical recommendation appropriate circumstances.
Tracking: Government agencies must gather as much information on rising antibiotic-resistant microorganisms as possible. Data such as risk factors that may be useful for prevention.
Improve prescriptions: Antibiotics prescription and usage needs to change. Most of the time, they are unnecessary for treatment of easy-to-cure infections, asking for professional advice before antibiotics will decrease inefficient usage. Make laws to restrict OTC antibiotics sale.
Development of new drugs: Resistance is a process that can be slowed but never completely stopped. Because of that, there must be a constant process of development of new antibiotics and diagnostic tests.