“Our doctors are using antibiotics unnecessarily sometimes. We have heard about ‘one shot doctors’. It is they, who prescribe antibiotics for some simple diseases such as cold and fever. Hence the public must understand that these ‘one shot doctors’ are wrongdoers”
“Sore throat? Why don’t you take some antibiotics?” This is the advice, we hear quite often by our closest friends and relatives who prescribe medicines such as doctors. Whenever there is a cold, fever or some other regular illness, antibiotics has been a mantra for them. Those who promote antibiotics thinking that it is the best or rather the only saviour, might not be aware of the term ‘antibiotic resistant’.
The Ministry of Health and Indigenous Medicine organised a symposium - ‘Containment of antimicrobial resistance and infection prevention and control’ last week. There, numerous scholars, based on their studies and other international findings, presented valuable facts with regard to the use of antibiotics and its aftermath in Sri Lanka and in the World.
Misusing antibiotics
While antibiotics fight bacterial infections such as bacterial pneumonia and urinary tract infections, many doctors and laymen tend to prescribe antibiotics for some virus infections, which is a highly criticised, erroneous practice.
The rise of bug resistance making antibiotics less responsive, is the danger of misusing antibiotics. When antibiotics may no longer be effective, common diseases may lead to serious illness or death.
According to the World Health Organisation (WHO) the misuse of antibiotics has led to 0.7 million deaths annually in the world. This number will go up to 10 million per annum by 2050. These alarming study findings show the importance of fighting against the threat of antibiotics.
“Our doctors are using antibiotics unnecessarily sometimes. We have heard about ‘one shot doctors’. Those are the ones, who prescribe antibiotics for some simple diseases such as cold and fever. Hence the public must understand that these ‘one shot doctors’ are wrong doers” said Deputy Director General (Laboratory services) Dr. B.V.S.H. Beneragama at the symposium.
Dr. Beneragama said some Ayurvedic doctors also prescribe Western medicines including antibiotics to their patients. “Nevertheless, we have changed a considerable amount of such malpractices by educating them through a series of workshops and seminars,” he said.
Asia, most affected
WHO statistics show that Asia is the most affected region in terms of antibiotics misuse. As there’s a prediction of 10 million annually by 2050, almost half of those deaths has a chance of occurrence in the Asian region. That is quite significant as even Africa, a continent consisting of the least developed countries in world, is slightly behind Asia.
Director General of Health Services, Dr. Anil Jasinghe said that Sri Lanka’s National Health Action Plan initiated under the universal ‘One Health’ program has targeted this key issue. “First and foremost we will educate the public about this matter. Meanwhile, we have already commenced Infection Control Units in all base hospitals to fight the threat of antibiotic resistance” he said.
One of the key orators of the symposium, Consultant Microbiologist, Sri Jayewardenepura General Hospital, Dr. Kushlani Jayatilleke said that it is important to look at the veterinary and environmental sectors too, in fighting antibiotic resistance.
According to the data shown by her, Carbapenem, a highly effective antibiotic, shows a 30.7% resistance in Sri Lanka, which is a shocking level. Whereas Greece, being the highest Carbapenem resistant country in Europe, records a bare 0.18% resistance.
It was also revealed that Sri Lanka taking a step forward, has published a circular on Red Light Antimicrobials, which cannot be issued to a patient by a general physician without the consultation of a microbiologist.
During her speech, Professor of Pharmacology, Faculty of Medicine, University of Colombo, Prof. Priyadarshani Galappatthy said that 50% of antibiotics are prescribed unnecessarily. Amoxicillin is the commonest prescribed antibiotic (58%) in Sri Lanka.
She also spoke of the growth of antibiotic use in Sri Lanka. There were only 70 antibiotics in use in 2010 with a gradual increase to 90 in 2017. “The cost for antibiotics has also increased significantly. In 2010 the antibiotic costs the country Rs. 2.1 billion, whereas it was Rs. 2.9 billion in 2017.
In Sri Lanka, 12.5% of the total drug budget, is allocated for antibiotics” said Prof. Galappatthy.
Another key point raised at the symposium was that most of the drug manufacturers in the world do not invest in new antibiotics as it is not of economic benefit to them. Because of the high use and increase in resistance, most of these drugs become ineffective in a shorter time period, making large investment on new antibiotics an economic hurdle for manufacturing companies. Prof. Galappatthy said, the antibiotics industry needs a US$ 5 billion investment annually.
The vacuum created by these profit - oriented stakeholders in the healthcare sector is also one of the main challenges the world needs to address.
Do’s
- Take the prescribed dose of antibiotics exactly as advised by the doctor
- Complete the full course of antibiotics, even if you are feeling better.
- Prevent infections by regular hand washing and good hygiene practices.
- If you develop side effects such as allergies and continuous diarrhoea, stop taking the antibiotics and consult your doctor.
- Store antibiotics properly. Keep in a cool, dry place.
Don’ts
- Buy antibiotics directly from pharmacies without a prescription.
- Stop or change the dose of antibiotics, even if you’re feeling better.
- Give your prescribed antibiotics to someone else.
- Take leftover antibiotics.
Facts
- Ten million deaths annually by 2050!
- 50% of antibiotics are prescribed unnecessarily
- Sri Lanka’s annual antibiotics drug bill – Rs. 12.9 billion (12.5% of the total drug cost)