ISLAMABAD: Due to the irrational use of antibiotics in developing countries such as Pakistan, a superbug can be created at any time that is not vulnerable to any antibiotics.

According to health experts, people should stop taking antibiotics without prescriptions, and doctors should stop prescribing antibiotics without a culture sensitivity test, as infections are already becoming more difficult to treat because of antibiotic resistance.

In addition, meat and vegetables also contain low concentrations of antibiotics due to the use of veterinary and agriculture medications, which is more dangerous than a full antibiotic course during an infection.

Health experts warn of antibiotic resistance due to irrational use, overprescription of antibiotics

A recent report titled Review on Antimicrobial Resistance estimates that 700,000 annual deaths around the world are attributable to infections by drug-resistant pathogens; if the situation continues to go unchecked, the deaths could increase to 10 million by 2050.

In light of this threat, the World Health Organisation has called for a World Antibiotic Awareness Week to be observed between Nov 13 and Nov 19, under the theme: ‘Seek advice for a qualified healthcare professional before taking antibiotics’.

Dr Waseem Khawaja from the Pakistan Institute of Medical Sciences told Dawn that antibiotics are among the most commonly prescribed drugs used in human medicine, but up to 50pc of the time, antibiotics are not prescribed by doctors in Pakistan, leading people to take incorrect doses or take the medication for the incorrect duration.

“Bacteria have internal intelligence, due to which it changes itself according to the medicines and creates resistance to the medicines. In the past, viruses could be killed with low potency medicines, but now high potency medicines are required for the same virus, which is due to antimicrobial resistance,” he explained.

Dr Khawaja said health officials and the public need to be made aware of the situation, as “a superbug can be created anytime which may not be killed by any antibiotic”.

“The government has also started a national action plan, which will include the capacity building of doctors, nurses and paramedics, and the issue of antimicrobial resistance will also be included in the medical curriculum to raise awareness among students,” he said.

In response to a question, Dr Khawaja said that global efforts in this regard began under the WHO in 2015.

“However, the issue is very complex because there are a number of stakeholders. Antibiotics are used in the agriculture sector, and the animal and poultry sector, due to which, human beings suffer as they consume the agriculture, meat and poultry products,” he added.

Drug Regulatory Authority of Pakistan CEO Dr Mohammad Aslam said antimicrobial resistance is one of the most serious issues facing humans.

“With the consultation of the WHO, Pakistan has been doing a survey to know what quantity of raw material for antibiotics is being imported and consumed in Pakistan. After that, consumption will be divided on a per-bed basis in hospitals to see how much medicine is being used in Pakistan,” he said.

Dr Aslam added that the low concentration of antibiotics from animals and agricultural produce creates resistance in bacteria. Moreover, he said, antibiotics also travel into the drainage system through human waste, creating resistance in the germs in drains.

“Another issue is that initially, first and second generation antibiotics were invented which were basic and simple treatment. Then third and fourth generation antibiotics were invented which are very powerful. Unfortunately, pharmaceutical companies have been marketing the third and fourth generation antibiotics [for higher] profits.

“Senior doctors also suggest third and fourth generation drugs because of their quick affect. When powerful antibiotics are used, first and second generation antibiotics become ineffective,” Dr Aslam said.

According to acting Executive Director of the National Institute of Health Dr Amjad Ali, Pakistan is witnessing a rising antimicrobial resistance problem, and antibiotic-resistant infections are contributing to more deaths, more chronic infections, longer hospital stays and higher treatment costs.

He said that with the passage of time, the scientific problem will become a political issue. He suggested that people should ensure their vaccinations are up to date, limit close contact with unwell individuals and should not share antibiotics with other.

Published in Dawn, November 19th, 2017