Education of doctors and patients is the key to rational use. Physicians should understand their role in saving antibiotics and using them sensibly. Patients should understand that antibiotics are not required in most minor infections and do not require doctors and pharmacists.
In a society quickly dependent on antibiotics, an increasing number of patients have begun to rely on antibiotics even for minor viral infections, such as a cold or a cough that they do not have. Simple home remedies, such as hot soup or coriander water or gargle and bed, are often not a choice. Even doctors have been found guilty of prescribing antibiotics for such minor ailments, either because of ignorance or the personal benefits of pharmaceutical companies supplying these drugs.
Although the benefits of antibiotics in combating bacterial infections are impressive. But they must be prescribed with caution and appropriate treatment protocols must be followed and the prescribing physician prescribed them.
Former chairman of Sri Lanka College of Microbiologists and senior lecturer in microbiology, University of Colombo, DR ENOKA COREA tells us how to take antibiotics and when, and spells, it's easy to follow the guidelines that should be taken into account when using them.
Fragments of an interview with the Sunday Observer …
P.: The microbiologists will meet this week to observe the Antibiotic Awareness in the world (November 13-19). Do the benefits for our readers tell us what antibiotics are and why should we raise awareness about them around the world?
BEHIND. Antibiotics are medicines that we take to fight bacterial infections. With the advent of antibiotics in the 1950s Serious infections, such as bacterial meningitis, pneumococcal pneumonia or tuberculosis, became susceptible to treatment. However, these profits have been lost because more and more bacteria have developed resistance to antibiotics. This means that infections with these resistant bacteria are difficult to treat, causing more complications and even death.
Q. What does an antibiotic do to protect human health?
BEHIND. Antibiotics, when used rationally and carefully, are able to reduce disease and death due to bacterial infections.
Q. Do antibiotics fight against viruses or diseases related to bacteria?
BEHIND. Antibiotics are only effective against bacteria. They are not necessary in viral infections because they will have no effect.
Q. Are there different types of antibiotics? I understand that there are four types.
BEHIND. There are more than four groups of antibiotics, such as penicillins, cephalosporins, tetracyclines, macrolides, etc. They have different chemical structures and act at different places in the bacteria.
P. Resistance to antibiotics is a new health problem. Just as antibiotics fight infections, abuse can also harm the person. Your comments?
BEHIND. Unnecessary use of antibiotics, such as viral infections, exerts selective pressure on resistant bacteria to reproduce and spread, which has exacerbated the problem of resistance to antibiotics. Unnecessary use of antibiotics may also harm the person taking the medicine because side effects (such as diarrhea) or even toxic effects of the medicine may occur. Antibiotics may also interact with other medicines taken by a person and make them ineffective or the combination may be toxic.
Q. How do you evaluate treatment protocols to prevent antibiotic resistance?
BEHIND. Published guidelines have been published on what kind of infection requires antibiotic treatment, which antibiotics are required in each case, and the dosage and duration of antibiotic therapy. Physicians should follow these recommendations when prescribing antibiotics.
Q: What about pregnant women? Do you recommend antibiotics? If so, what time of pregnancy and what infections?
BEHIND. Some antibiotics can penetrate the placenta and have a detrimental effect on the child. Therefore, these antibiotics are contraindicated during pregnancy. However, there are other groups of antibiotics that can be safely used in pregnancy if a pregnant woman gets a bacterial infection such as urinary infection.
Q.: Some patients have the habit of repeating the same drugs over and over again, using the same prescription given before, instead of visiting their doctor to renew it. Can this practice threaten their health? How?
BEHIND. Antibiotics recommended for a single infection may not be effective for other infections. For example, antibiotics administered to treat urinary infections may not be effective for lung infections. Therefore, it is not appropriate to use the same prescription in case of another infection. Most pharmacies will not dispense medicines for the old prescription, especially for antibiotics.
Q: Some patients also do not finish the prescribed antibiotic treatment and stop halfway when they feel good. Can the given dose of prescribed antibiotics harm them?
BEHIND. It is recommended that you complete the entire course of the antibiotic according to the instructions that the bacteria be completely removed from the body. If you stop antibiotics too soon before the bacteria are eliminated, the resistant strains can start taking control and the infection can be repeated. This relapse will be more difficult to treat and may require stronger and more expensive antibiotics.
Q. Children? Do you prescribe antibiotics to infants, young children and children under 5 years?
BEHIND. Most antibiotics can be safely used in children. Doses should, however, be adjusted depending on the child's body weight. There are some antibiotics that can damage growing bones and teeth and are contraindicated in childhood.
Q. Can bacteria resistant to antibiotics cause infection in children?
BEHIND. If antibiotics are misused in any community, the bacteria in this community will gradually become resistant to these antibiotics. When these antibiotic-resistant bacteria spread in the environment and between people, they can cause infections in children and adults.
Q. What are the long-term consequences of irrational use of antibiotics in human health?
BEHIND. Prolonged irrational use of antibiotics will increase the spread of antibiotic-resistant bacteria in society. They will replace other bacteria and become dominant strains. Therefore, most of the infection in the community will be caused by these resistant bacteria. Such infections will be difficult or impossible to treat and will result in greater mortality from infections.
Q. What are the gaps in the current system for prescribing antibiotics? Explain in detail.
BEHIND. When a patient visits a doctor, he expects the doctor to prescribe some medicine, even for something trivial, like a cold or a cough. Therefore, doctors feel compelled to prescribe antibiotics, even if they know that it will not be useful. We need to make the public aware that many infections, especially viral infections, will improve themselves within a few days and that medications are not required and can be harmful.
Physicians should also spend more time explaining their illness to their patients so that the patient is calm, that drugs are not needed.
Q. Do you think that there should be more regulation regarding the prescription of antibiotics, are existing ones sufficient, but need more teeth to implement them?
BEHIND. The regulations clearly state that antibiotics should only be given on the basis of the current prescription and should not be available "without a prescription". Although it has been easy enough to get antibiotics without a prescription a long time ago, pharmacies are much more restrictive when it comes to implementing legislation. This is a great improvement.
Q. The Infectious Diseases Society of America is campaigning for rapid antibiotic approval for a limited population of patients to treat serious or life-threatening infections with several treatments or the absence of appropriate existing treatment. Your comments?
BEHIND. Such new treatments will be very expensive and completely inaccessible to our patients. It is much better to preserve the resources we have and carefully use antibiotics so that we can be effective.
Q. What priority is the role of education on antibiotics, why they are used and how should they be used to help the whole community?
BEHIND. Education of doctors and patients is the key to rational use. Physicians should understand their role in saving antibiotics and using them sensibly. Patients should understand that antibiotics are not required in most minor infections and do not require them from doctors and pharmacists.
Q. Your message to the public?
BEHIND. Antibiotics are not effective against viral infections such as colds or flu. Antibiotics are a valuable resource and should be preserved and used with caution and wisdom. Taking antibiotics when they are not needed causes the bacteria to become resistant to them. It exposes your children and future generations to the risk of incurable infection. Never take antibiotics without a prescription. Try to prevent bacterial infections by following good hygiene practices such as regular hand washing, eating hygienically prepared food and drinking cooked chilled water.