Published:  01:53 AM, 13 September 2017

Abuse of antibiotics raises health hazards


When antibiotics were first invented, these were seen as 'Magic Bullets' that brought a radical change in the treatment of infectious diseases. Now, however, experts are worried that the 'golden age of antibiotics is over'. It was observed in a research concluded recently on problem of drugs against the random use of antibiotics which were mostly ineffective and harmful.

The research conducted by Health Action International (HAI) was published recently with recommendations for the establishment of national and global policies on the appropriate use of antibiotics. The research, started with an example of deaths of 37 patients including seven children in India in 2013 for taking a life-saving antibiotic, said the use of antibiotics "has set in motion the biggest intervention in populations' genetics seen to date on this planet". The effects of that intervention are seen in the distributions of antibiotic resistance genes throughout the world's bacterial populations.

The research said this change, although invisible with the naked eyes, has had as profound effect on human health as the antibiotics themselves, adding that the key reason for the baffling array of so many antibiotics is "the rapid development of bacterial resistance to every compound that has reached general use". The research said the resistance to antimicrobial agents has become a global problem with a major impact on healthcare in developed and developing countries.

A possible reason for the dramatic increase in streptococcus pneumonia strains resistance to penicillin in Hungary over a 40 years period from 1975 to 2015 was "the uncontrolled, injudicious, and frequent administration of penicillin and its derivatives", the research said adding with a call for an antibiotic policy that would limit the use of antimicrobials as one of the more effective ways to prevent the further spread of resistant strains. Examining the problems  of resistance among streptococcus pneumonia strains in Spain, the researchers concluded that two essential measures seemed necessary to improve the situation: "exhaustive surveillance of resistance and strict control of antibiotics use".

The research quoting the meeting of World Health Organization (WHO) working group in the Western Pacific region said bacterial resistance was a problem in Australia, Brunei, China, Hong Kong, Japan, Malaysia, New Zealand, Papua New Guinea, the Philippines, South Korea, Singapore and Vietnam. It has called for an information network in the region to monitor the situation.

The researchers said the inability to treat infections with the usual antibiotic of choice or any other drug can be disastrous. Gonorrhea, dysentery, pneumonia, meningitis and deadly hospital infections are all taking their toll.  The misuse of antibiotics increases the dangers of side effects. These may be specific, for example, chloramphenicol can damage the bone marrow, neomycin may damage the kidneys, and most classes of antibiotics may have some negative effect on male fertility.

The eight drugs most commonly implicated included three antibiotics: ampicillin, amoxicillin and contrimoxazole, the research said quoting a study concluded in the USA in 2016 that 71 percent of pediatric outpatient prescriptions were for antibiotics. Another study conducted in the USA in 2016 said over 85 percent of the drugs used in animals in the USA were used without veterinarian involved.

The research also said the use of antibiotics is widespread in industrialized countries. In Sweden, antibiotics prescribing increased by 14 percent between 2013 and 2014.  In the UK, one in every six prescriptions is for antibiotics. In Australia, antibiotics accounted for 17-20 percent of all drugs prescribed, and in 2015, amoxicillin was most widely prescribed of all drugs. In 2015, the most often prescribed drugs in the USA was a brand of amoxicillin, amoxil' produced by Beecham.

A survey in the USA showed that 60 percent prescribed antibiotics for treating colds. In the UK, about one-third of all hospital patients receive at least one antibiotic, and in about half of these cases, the antibiotic is inappropriately prescribed.

A Canadian study found that at least one-third and perhaps as much as one half of antibiotics were inappropriately prescribed in hospitals. The vast sale of antibiotics in Italy in 2013 (Tk 50 billion) prompted the Italian health ministry to comment that this enormous consumption "unfortunately confirms the indiscriminate and often unjustified use of antibiotics therapy for the treatment of frequently being infections".

The research said the global antibiotics market was put at Tk 930 billion in 2014, and estimates suggested that it would increase to Tk 12,00 billion by 2015 and a possible Tk 2,000 billion by the year 2019.  Promotional material for Smith Kline's ampicillin and eskaycillin in Bangladesh in 2014, claimed that antibiotic was 'highly successful' in a wide range of infections. It cited studies which it claimed showed a success rate of more than 90 percent in respiratory tract infections: 86 percent in bacillary dysentery and 88.4 percent in bacterial enteritis.

The research said penicillin, quinolones, macrolides, lincomycin groups, streptomycin and other aminoglycosides, including getamicin, amikacin, framycetin, kanamycin, neomycin, netilmicin, paromomycin, sisomicin, tobramycin, chloramphenicol, tetracycline, co-trimoxazole of different multi-national companies marketed throughout the world have a broad spectrum of action, but due to resistance and severe side effects their usefulness is limited. They can cause deafness, harm the kidneys and cause muscle weakness and decreased respiration, especially when they are used in high doses or for a long time. They can produce severe allergic reaction and should not be used in pregnancy.

The researches recommended six programs against the random use of antibiotics and its adverse reactions. These include ban on antibiotics with combinations, or other controls on the advertising of antibiotics, introduction of regular refresher courses on health, and above all introduction of strict antibiotic policies as part of a national drug policy.

 



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