The discovery of antibiotics was heralded as one of the greatest finds of the 20th Century. Antibiotics have saved hundreds of millions of lives.
In the next decade the world will see 100 years of antibiotic use, but will this be in celebration or in mourning?
Antibiotic use has spread like wildfire across the globe, but there is a caveat to their use, resistance. Antibiotic resistance refers to bacteria that are not killed when exposed to antibiotics. Essentially, such bacteria develop the ability to defeat the action of drugs designed to kill them.
What is expected when one uses an antibiotic? That the antibiotic destroys all the organisms that have led to the disease. However, in some circumstances, some bacteria that caused the disease (or other bacteria that may not have been involved) are not destroyed by the antibiotic. Those that survive the drug assault become resistant.
What is so worrying about antibiotic resistance? The fear is that antibiotics previously useful in treatment of life-threatening bacterial infections would no longer be of any use.
As with any complex problem, there is no one-stop solution to antibiotic resistance. It takes a village! Concerted interventions, not only to prevent flourishing of resistant organisms, but to also curb the spread of the resistant organisms, are needed.
Prevention of development of resistant organisms is centred on curtailing unnecessary exposure of bacteria to antibacterial agents, stopping bacteria-antibiotic mismatch, correct dose of antibiotics and avoiding unnecessary antibiotic use in humans and animals.
The implementation of these measures should be observed at all levels — the patient, healthcare practitioners, pharmaceutical companies, drug regulatory boards, governments and other local/regional/world health organisations.
What role do you play towards development of antibiotic resistance?
Take 1: Where one develops a cough, sore throat or running nose. In most cases, sadly, the person reaches for the nearest antibiotic. Studies have revealed that over 80 per cent of people with the symptoms mentioned do not have a bacterial, but a viral infection which is not treatable by an antibiotic.
Take 2: In cases of bacterial infections when antibiotics are actually needed, do you complete the dose as prescribed by the doctor? Is there an instances where you have received/given an incomplete antibiotic dose from/to a relative, colleague or friend, without being tested? If the answer is yes to either question, you may be contributing to resistance.
Failure to test before treatment, under dosing, over dosing, failure to complete prescribed dose are some resistance drivers. It is crucial that such practices stop.
How else can antibiotic resistance be prevented?
Prevention of the spread of resistant bacteria. Again, this should be a concerted effort. Aspects as basic as correct handwashing to more technical action such as isolation and identification of drug resistant bacteria and their targeted treatment are critical. Hospitals and other health facilities are important points of such intervention.
What does the antibiotic future hold? What would seem an obvious solution is the development of new antibiotics, but it is not. Why? Development of antibiotic resistance seems has overtaken drug development; development path of an antibiotic from molecule synthesis to patient use takes a very long time and costs billions of shillings, yet it is a process that cannot be bypassed.
Ideally, the drug manufacturer would like to get return on investment from sales of the drug; abuse of the drug would rapidly lead to resistance; investing in antibiotic development may seem a non-worthwhile investment from a manufacturer’s point of view; the pharmaceutical industry has not produced a new molecule for a number of years now partly due to the aforementioned reason, but mostly because of change of focus to non-communicable diseases such as cancer and lifestyle diseases.
As it stands the reachable and sure weapon against antibiotic resistance lies with us.
Ms Mwangi is a researcher at University of Nairobi’s Institute of Tropical and Infectious Diseases