Misuse of antibiotics must be controlled

It is worrying to note that in Bangladesh antibiotics are losing their effectiveness to kill pathogens. According to a national daily yesterday, the government’s Institute of Epidemiology Disease Control and Research (IEDCR) started surveillance over effectiveness of 18 antibiotics in 2017, and found that 11 antibiotics are now less effective against 10 pathogens. The bacteria who are known as ‘superbugs’ have shown resilience against these antibiotics that are not effective in curbing infections as they are supposed to be. It is happening for the six per cent of the examined bacteria that caused these infections.
Why are antibiotics losing effectiveness against diseases in Bangladesh? The simple but overwhelming answer is their misuse. Taking antibiotics without prescription from the registered physician, often at the advice of the drug sellers, has become so popular that antibiotics are often taken without their appropriate dose and completing the course.
As a result, bacteria and parasites are developing resistance against the pathogens. The consequence of it is very dangerous. Antibiotics are life saving drugs, and if they lose their effectiveness against lethal diseases, surely mortality cases from these diseases will rise.
That antibiotics are becoming less potent against pathogens is no new news. This is a worldwide phenomenon and for quite a long time this remains a serious worry for pharmacists and physicians everywhere. In the relatively underdeveloped countries including Bangladesh, misuse of antibiotics mostly occurs. But the sad part of the matter is the government as well as the community of health professionals in Bangladesh has done precious little to check misuse of antibiotics.
Even many drug sellers do not know an antibiotic to be an antibiotic. Take for example the drug called Metronidazole. It is one of the finest but mostly misused antibiotics in Bangladesh. For a stomach upset, most people take this drug routinely. After two or three doses when the condition of the stomach improves people usually stop taking the medicine not knowing that he has to take the full course of it. This antibiotic is also effective for surgery patients and is given to prevent infection. But withdrawal of this medicine not only makes stomach bugs stronger against the drug, it makes it less effective against pathogens that can cause infection after surgery.
Even higher class of antibiotics is also misused, the IEDCR surveillance has found. Ineffectiveness of four out of six critically important antibiotics listed by the WHO has increased up to 84 per cent during the last one year. The list includes Ceftazidime, Cefixime, Cefepime and Ceftriaxone. Azithromycin has also fallen to 53 per cent from 55 per cent while Ciprofloxacin remained at 66 per cent.
This surely does not bode well for the public health in Bangladesh. If misuse of antibiotics cannot be checked, it will be difficult to treat diseases like urinary tract infections, septicaemia, diarrhoea, pneumonia and wound infections that can be lethal.