Prudent use is the only way to solve antibiotic resistance

Alexander Fleming's accidental invention of penicillin in 1928 led to a revolution. As antibiotics were developed, bacterial disease like diarrhoea, which was once a fatal disease, found a cure. 

Later, in the 1940s most of the antibiotics we use today were discovered. And the development of various types of antibiotics against different kinds of bacteria has been going on ever since. But it is sad that today people are getting resistant to antibiotics just because of irrational use of them.

Prudent use of antibiotics is urgently necessary if we are to stop the processes that often lead to our bodies becoming resistant to various antibiotics. Prudent use of antibiotic means using the drugs in appropriate time, appropriate doses, appropriate duration and through appropriate route. 

Firstly, irrational use of antibiotics can make a person resistant to certain drugs. We often see antibiotics being used for the viral diseases on which no investigation has been conducted. In case of a viral disease, taking antibiotics is unnecessary since recovery from such diseases is guaranteed within five to seven days. But, the patient is having the antibiotics anyway. 

Secondly, the appropriate doses of antibiotics are every necessary. We have some international guidelines and according to it one cannot prescribe an inappropriate medicine other than the proper one. For example, the antibiotics used for

Tuberculosis will not work for other diseases. That is why we suggest that people use antibiotics rationally through a programmatic approach. 

Thirdly, a disease might go away with a lower dose of antibiotics. But doctor you have visited had prescribed a higher dose medication. This also contributes to the development of resistance as the lower dose will cease to work for that disease later in the patient's life.

Lastly, suppose a person will have to take antibiotics for seven days. The patient has stopped taking the medication after five days, since the doctor's prescription. Though the person apparently cured of the sickness, but what actually happens in this case is, some of the bacteria remain. Later on, when the same drug is used, these bacteria fight against the medicine, which in turn make the patient resistant to the medication. 

Pharmaceuticals industry is also responsible for imprudent use of antibiotics. For example, the dose written in a medicine is 500mg, but the manufacturing companies have used 400mg. Doctors might prescribe the medicine unknowingly, but what will actually happen is that, as the dose is lower than the necessary amount, it will turn as irrational use of antibiotics.   

Now, is it only through consuming prescribed antibiotics that we are becoming registrant? The answer is in the negative. Antibiotics are getting inside our body through various means and the most common insertion is through foods. 

It is sad, but nowadays businessmen are massively using antibiotics in the poultry and livestock food products. As a result, when we are consuming chicken, beef, fish and even vegetables, antibiotics are getting inside of our body. And it is a major reason behind the most of us becoming resistant to the antibiotics. 

In our country, most of the people still live in villages and the primary advice they get from the attendant at the village medicine shops. In these cases, the inexperience store keepers suggest that consumers need to buy various antibiotics to cure themselves. This certainly is one avenue through which irrational use of antibiotics continues. 

Now a question arises, what happens to the person who is resistant to antibiotic? It is not that the person will instantly die of the disease, but the treatment process becomes lengthier and costlier in this scenario. Because, physicians will need to treat the patient differently with newer antibiotics and this will take time. For example, if a disease could be healed within seven days, the same disease for a resistant person will take few months and the cost will thus rise proportionally. 

To stop the cycle of antibiotic intake and patients who develop resistance, every stakeholder related to the health industry would have to coordinate and work together. In the first place, the doctors before prescribing antibiotics will need to scrutinise the disease thoroughly. They have to be conscious as well of the consequences of all the antibiotics they regularly prescribe. Next, the pharmaceutical companies would have to be aware and honest. Additionally, they would need to abandon their marketing policy of incentivising the doctors. The village medicine shops should be brought under surveillance to ensure that no medicines are sold without prescriptions. And, lastly the patients need to be aware as well that they should not buy any antibiotics without proper consultation.  

It is no good news that antibiotic resistance might take the form of an epidemic within few decades. Thus, the sooner everyone realises that they need to act and become aware as fast as possible to prevent this from happening, the better. 

Dr Ruhul Furkan Siddique is a former Director, Directorate General of Health Services and currently working as Professor, Department of Public Health and Informatics in Jahangirnagar University