The rampant use of antibiotics for every infection under the sun will soon make them useless against the ones they were invented to treat in the first place.
People tend to use antibiotics for viral infections without first consulting a doctor and shortening the dose and duration on your own makes them less effective by allowing microbes to develop resistance against them.
Infections can then persist for a long time and may even become life-threatening because no medicines exist to treat them.
Penicillin, a broad-spectrum antibiotic sold under various brand names such as Augmentin, Amoxicillin, Amoxi-Clav, Moxilium, is already on the way to stop working, said Dr Muhammad Osama Rehman, infectious disease specialist from Ziauddin Hospital Clifton, at a workshop during antibiotic awareness week on Friday.
Because the symptoms of viral and bacterial infections are often similar, it is difficult for the layperson to tell the difference, said Dr Rehman, advising people to rely on their doctor to tell you when to use them.
When people have diarrhoea, they take metronidazole — sold under brand names such as Flagyl, Danizole, Entamizole — without realising it’s an antibiotic, said Dr Sunil Kumar Dodani, assistant professor at the Sindh Institute of Urology and Transplantation (SIUT).
He added that fever and diarrhoea are usually viral and self-limiting. It’s important to stay hydrated by taking ORS and plenty of fluids to manage the loss of water.
Experts from the Aga Khan University have warned that up to 95% of the population of Pakistan could be carrying bacteria resistant to life-saving antibiotics.
This scenario has already started playing out in hospitals where around 50% of infections are no longer susceptible to antibiotics, estimates Dr Azizullah Khan Dhillo, an infectious disease specialist.
The alarming situation is now taking us back to the pre-antibiotic era where advanced medical interventions may become compromised, said Dr Rumina Hasan, a professor of microbiology at the AKU, during the seminar in Karachi.
This could mean most surgical procedures such as organ transplantations, cancer chemotherapy, diabetes management, caesarean sections or hip replacement would no longer be possible.
“Antimicrobials have also been instrumental in the control of infections in farm animals and in crops, allowing an increase in agricultural output and providing food security. Emergence of antimicrobial resistance (AMR) threatens this progress,” Dr Hasan added.
The use of antibiotics in veterinary medicine and livestock, has led to antibiotics entering our food supply and further increasing antimicrobial resistance.
Dr Bushra Jamil, president of the Medical Microbiology and Infectious Diseases Society of Pakistan, believes that immediate coordinated action with different stakeholders including farmers and the agriculture industry is necessary to monitor and control this practice.
A National Action Plan for AMR was released in 2017 but has never been implemented properly. A surveillance system, which would monitor human and animal antimicrobial usage, the NAP calls for is still not in place.
Antibiotics are easily available over the counter without prescriptions at medical stores and pharmacies across the country.