Antimicrobial resistance has been named one of the top ten global public health threats to humanity according to the World Health Organization (WHO). It has been estimated that by 2050, ten million deaths per annum could occur as a result of antimicrobial-resistant infections. This will make it more deadly than cancer. This highlights the importance of acting promptly and understanding the roles and responsibilities of our society to preserve the efficacy of our remaining antimicrobials. 

Infections sometimes impossible to treat

Antimicrobial resistance occurs naturally over time, but the overuse/misuse of antimicrobials is accelerating the process. Microorganisms, constantly being exposed to antimicrobials have started fighting back, and have developed mechanisms to resist antimicrobials. This has resulted in infections now becoming increasingly difficult and sometimes impossible to treat. 

Antimicrobials, which refer to anti-infective medicines such as antibiotics, antifungals, and antivirals, are precious resources that require urgent safeguarding. Antimicrobial stewardship, therefore, refers to a coordinated effort to ensure that the correct antimicrobials are used for the type of infection, that therapy is tailored to the microorganism causing the infection, that the dose is optimal, and that the duration of therapy does not extend beyond the timeframe sufficient to successfully treat an infection.   

Misuse of antibiotics a ‘grave concern’

The misuse of antibiotics in particular is of grave concern. Antibiotics are indicated for the prevention and treatment of infections caused by bacteria. Different types of antibiotics are effective against different types of bacteria, but they are not effective against viruses, and can therefore not be used to treat common colds, flu, or even COVID-19. The more antimicrobial resistance increases, the faster we are running out of antimicrobials to effectively prevent and treat infections. The lack of development of new antibiotics is contributing to the concern. Even though new antibiotics will likely not reach the market in the near future, it is imperative that antibiotic misuse changes now, as continuing on the current path will render new antibiotics ineffective soon after becoming available. 

Because colds and flu cannot be cured with antibiotics, other over-the-counter medicines can be considered to help relieve symptoms, such as paracetamol, ibuprofen, antihistamines, nasal sprays, cough mixtures, throat lozenges, and mucolytics. Your pharmacist would be able to advise on the best combination of taking your history, comorbidities, allergies, and chronic medications into consideration. 

Antibiotics can be harmful

One must also keep in mind that all medicines, including antibiotics, have side effects. Although antibiotics can be life-saving, they can at the same time also cause harm. Although they are intended to destroy the bacteria causing infection, they also tend to destroy the healthy bacteria in our gut. This creates an opportunity for good bacteria to develop resistance that may cause difficult-to-treat infections in the future. Fungal infections also to thrive after antibiotic therapy due to the disturbance of the healthy microbiome. Exposure to antibiotics can lead to complications such as developing an infection caused by a bacteria called Clostridioides difficile, which presents as life-threatening diarrhoea and inflammation of the colon. 

Only use when truly needed

Doctors are often pressurized to prescribe antibiotics due to patients already having self-diagnosed and expecting an antibiotic prescription after their consultation. A doctor’s prescription is required for antibiotics. Should a doctor not deem the prescribing of antibiotics necessary, it is likely due to the fact that that the infection is self-limiting and/or is being caused by a virus that can be treated symptomatically. Patients are encouraged to rather request for their doctor to not prescribe antibiotics unless absolutely necessary. Antibiotics are miracle drugs that need to be handled with care and reserved for instances where they are truly needed. Your doctor would undoubtedly know in which instances they are truly needed.

All South Africans are urged to join the fight against antimicrobial resistance. You have a role to play, and the time to act is now. – Health-e News

*Michelle Gijzelaar is the Clinical Pharmacy Specialist at Life Healthcare