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Antibiotics Abuse: Another Example of Poor Access to Health Information

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Access to quality health information and support will go a long way to ensure a lot more people use their medications properly and for the right conditions.Across the world there has been reports of some antibiotics no longer ‘work’. People visit hospitals repeatedly to treat the same bout of malaria or fever. It is widely believed that fake drugs are the culprits, this may not be entirely true.

To be pro-active, we have to consider other reasons why our antibiotics seem to be failing us. Resistance will rank high amongst other possible reasons. We have begun to use antibiotics that were previously reserved for more complex cases to treat simple infections like cough! Why is this so?

The following events happened in a community pharmacy in a upper middle class area of Abuja, Nigeria. The dialogue is between the pharmacist and two different patients with different educational backgrounds. Pointing to the fact that level of education is not a distinguishing factor in our attitudes and practices as related to antibiotic use as will be shown.

Scenario 1
Pharmacist:

Good day Sir, how may we help you?

Patient:

Oga pharmacist, how are you doing? I am travelling for the Christmas holidays
I need some antibiotics to ‘flush’ my system.
Please mix some very strong antibiotics for me.

Pharmacist:

Sir you need not take any antibiotics if you don’t have any infections.
You need to conduct some relevant laboratory investigations to determine whether you need treatment. Besides antibiotics don’t ‘flush’ the system.

Patient:

Oga thank you very much. I didn’t know all this before now.

Scenario 2

Pharmacist:

Welcome madam how may we help you?

Madam:

I was reading on the internet that fever is one of the signs of infection in children. My 4 month old baby has been running temperature for 2 days.
I want to buy Cefpodoxime suspension to treat the infection.

Pharmacist:

Madam there are many reasons why a child may develop high temperatures one of which is infection. It is not advisable to start administering antibiotics just yet. It is necessary to conduct some laboratory investigations to ascertain if there is any infection. Taking antibiotics when there is no infection or when a sensitivity test has been conducted can lead to the emergence of resistant strains of organisms.

Madam:

Thank you pharmacist I will take my baby to the hospital to see a doctor.

These two scenarios are often encountered by health workers in their day-to-day contact with patients in all settings. This happens especially in developing countries where there aren’t tight enough controls on access to antibiotics and many other drugs. Almost any drug can be bought over the counter.

This phenomenon if not checked will lead to the development of resistance of micro-organisms to antimicrobials (antimicrobial resistance). Antimicrobial resistance is said to occur when drugs for fighting infections become ineffective for instance, a malaria medicine that was originally effective to treat a bout of malaria stops ‘working’.

The World Health Organisation defines anti-microbial resistance as resistance of a micro-organism to an anti-microbial drug that was originally effective for treatment of infections caused by it. Antimicrobial resistance is now posing a huge public health concern.

Consequently, all hands should be on deck to halt this trend. Effective prevention and treatment of infections caused by either bacteria, viruses, fungi and other parasites is being threatened by the emergence of resistant strains of micro-organisms. Tuberculosis and Malaria are examples of infections that occur widely in developing countries. Cases of drug resistance has been reported.

Resistance to anti-tuberculosis drugs
In 2012 there were about 450 000 new cases of multi-drug resistant tuberculosis (MDR-TB). Extensively drug resistant tuberculosis (XDR-TB) has been identified in 92 countries.

Resistance to anti-malaria drugs
Sulphadoxine-Pyrimethamine combination and Chloroquine were the drugs of choice in the treatment of malaria. Over time the malaria parasite has developed resistance to these drugs. Artemisinin combinations (ACTs) were then developed. Resistance to this newer drugs may occur if the appropriate measures are not put in place.

Possible causes of antimicrobial resistance

  • Inappropriate use of antimicrobials leading to the emergence of resistance strains
  • Poor infection and control practices

There is an urgent need to halt the further emergence of antimicrobial resistance, a holistic approach is mandatory.

Such approach will involve individuals:

  •  Using antibiotics only when prescribed by a health professional
  • Completing the full course of treatment, even if they feel better
  • Not sharing antibiotics with family and friends who seem to have similar symptoms

Health professionals and Pharmacists should:

  • Enhance infection control and prevention
  • Prescribing antibiotics only when they are needed
  • Ensure the right antibiotic is prescribed to treat any particular infections

Scientists should conduct research to develop new drugs, vaccines and diagnostics to improve our options in infection control and treatment.

Health care providers can educate their patients on the proper use of their medications. This will ensure they remain effective for fighting infections.

This is most definitely the way forward for us to healthy lives whilst keeping dangerous germs at bay!.

About Olubukola Tikare

Olubukola Tikare is a qualified pharmacist with a Bachelor of Pharmacy degree from Olabisi Onabanjo University Ogun State Nigeria and a Masters degree in Clinical Pharmacy, International Practice and Policy from the School of Pharmacy, University of London. Her experience includes conducting field research and writing for leading global pharmaceutical companies. Her research centres on finding ways of improving access to healthcare in the African continent.

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