Misuse of antibiotics- at what cost?

By Niranjana S. Rajalakshmi, MVSc (Vet. Microbiology)

Science Writer (Freelance)

www.macroscopically.com


Since their discovery in the early 20th century, antibiotics have saved the lives of millions of people However, the overuse and misuse of antibiotics in humans, as well as veterinary medicine, over the past 5 decades have resulted in the emergence of strains of bacteria that no longer respond to antibiotics. This means treating infections is becoming increasingly challenging, posing a major public health concern!


How is this resistance acquired?

Antibiotics fight bacterial infections either by killing bacteria or stopping their growth. Because of antibiotic overuse, the bacteria learn to protect themselves from the drug or even neutralize the drug. They can develop mechanisms for stopping the antibiotic from reaching the target and modifying the targets that the antibiotic works on. They can no longer be killed by any antibiotic and are rightly called ‘superbugs’. Various genes carried by many types of bacteria are responsible for the resistance.


Once bacteria develop resistance, the genes causing the resistance can spread or be transferred to other bacterial species and spread to people around the world, making the antibiotics useless in fighting infections not just in an individual. But everyone!


For instance, NDM-1 (New Delhi metallo-beta-lactamase) is a gene carried by some bacteria that commonly inhabit the gut. These bacteria are resistant to some of the most commonly used and strongest antibiotics. NDM-1 was first isolated from a Swedish patient of Indian origin who travelled to India. This superbug is widespread in India, and by 2015, it was detected in 15 countries worldwide as people travel across countries frequently.


Here are some examples from people like us who have suffered with drug resistance.


Let’s take a look at the story of Mrs. Manal from Egypt and how antibiotic resistance affected her life.


Mrs. Manal is a mother of a middle-aged daughter and a teenage son. She was diagnosed with a benign cervical tumour and had to undergo surgery to get it removed. Things seemed fine for a while. Then, her life took a drastic turn. A few days after the surgery, she had a high fever, and the family had no idea why her body was showing a rise in temperature. Even though they managed to bring the temperature down, it would increase rapidly again.


Mrs. Manal was admitted to the hospital again and it was found that she had developed an infection at the surgical site. Mrs. Manal’s daughter was informed that her mother’s immune system was too weak to fight the resistant infection because of her practice of taking a huge amount of antibiotics without proper prescription. Mrs. Manal did not have the strength to combat the resistant bacteria attacking her body even after intravenous administration of several antibiotics at high dosages.


Sadly, none of them worked and the wound did not show any signs of healing! Mrs. Manal’s life entirely changed after this ordeal, and she was not able to even take proper care of herself or her family after this. The whole family went through a physically, emotionally and financially trying experience because of antibiotic resistance.


Now, Mrs. Manal advises people not to take antibiotics without a physician’s prescription and definitely not from a pharmacist. Although she survived this infection, many people are not so fortunate.


Here’s another story of a drug-resistant infection survivor:


Daphne Deckers is a Dutch author, television host, and anchor. In 2014, she was suffering from a bladder infection and was prescribed antibiotics for the same. However, even after completion of the course of treatment, she felt tired and was in pain. Even after another round of antibiotics, her symptoms persisted. Eventually, this went on and on.


One evening, after watching a television show, Daphne felt shaky and was hospitalised. She was put on an IV drip for five days; but even after that, the infection did not go away. The doctor told her that the bacteria that was causing the infection (a bacteria called E.coli), was resistant to multiple antibiotics. Usually, E. coli is sensitive to eight different kinds of antibiotics, but in Daphne’s case, seven of them did not work anymore. Then, Daphne had one last last chance – number eight, and luckily, it worked for her.


Bladder infections are something common and treatable. But what if the prescribed antibiotics do not work against the infection? Daphne says that this issue had a huge impact on her life, and it took almost a year to get rid of the infection. However, the situation would have been far worse if E. coli was resistant to all the eight antibiotics. If antibiotics stop working, we could succumb to simple bladder infections. The rate at which new antibiotics are being discovered is very slow so we must preserve the antibiotics we have by using them carefully. Daphne now campaigns to raise awareness about the threats of antibiotic resistance!


Antibiotics are precious tools that guard us against harmful microbes and have to be used properly. On account of antimicrobial awareness week, 2020 (18th November- 24th November), we, at Miyara Health, would like to strongly re-emphasize WHO’s slogan , “Handle antibiotics with care”.


** To upload prescriptions, health records and get health information, sign up for the Miyara app at www.miyarahealth.com**


References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6604941/

https://aac.asm.org/content/53/12/5046

https://timesofindia.indiatimes.com/home/science/New-Delhi-superbug-spreads-to-70-countries-across-the-world/articleshow/48998960.cms

https://www.youtube.com/watch?v=Vt_gYEAe03c

https://www.euro.who.int/en/health-topics/disease-prevention/antimicrobial-resistance/education,-awareness-and-behaviour-change/personal-stories/dutch-television-host-shares-personal-experience-with-superbug-infection

https://www.who.int/news-room/events/detail/2020/11/18/default-calendar/world-antimicrobial-awareness-week-2020



#healthmanagement #infectioncontrol #infectionprevention #antibiotics #handlewithcare #healthandyou #amr #superbugs #miyarahealth #healthcarebeginsathome

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