It’s been almost three years since the World Health Organization declared a global pandemic, and since then, antibiotics resistance has been pushed out of the headlines. Antibiotic resistance is one of the biggest threats to global health, food security, and development today. Antibiotic resistance leads to higher medical costs, prolonged hospital stays, and increased mortality.
The world urgently needs to change the way it prescribes and uses antibiotics. In this article, we cover what is antibiotics resistance, why it has become a global problem that threatens healthcare, and what to do to prevent it.
“A global catastrophe that threatens the lives of millions of people around the world.” This is how Antibiotic Research UK describes the phenomenon of antibiotic resistance. Overuse and misuse of these essential medicines is rendering some of them useless, putting us all at risk. But why and where is antibiotic resistance becoming a problem, and what can we do about it?
- Antibiotics resistance has the potential to affect people at any stage of life around the world.
- Antibiotic resistance is a threat to global health because it leads to increased mortality and longer medical stays.
- Misuse of antibiotics is accelerating the natural process of antibiotics resistance and makes treatment of dangerous infections less effective.
Antibiotics are a group of medicines that are used to fight bacterial and some parasitic infections. They do this by killing the bacteria that’s causing the infection, or stopping it from reproducing and spreading. Sometimes called antimicrobials or antibacterial, antibiotics can be taken in a number of ways including injections, tablets and creams.
Antibiotics are used to treat or prevent some types of bacterial infection. They work by killing bacteria or preventing them from spreading. But they do not work for everything.
Antibiotics do not work for viral infections such as colds and flu, and most coughs and sore throats.
Antibiotics are no longer routinely used to treat:
- chest infections
- ear infections in children
- sore throats
What do antibiotics treat?
Antibiotics should only be used to treat illnesses caused by susceptible infections.
They’re a vital weapon in the war against tuberculosis, for example – an illness that affected 10 million people worldwide in 2019 – as well as being used to fight infections including bacterial tonsillitis, urinary tract infections, respiratory tract infections, whooping cough and skin infections.
Different types of antibiotics target specific bacteria. For example, Amoxicillin (a sort of Penicillin) is often prescribed to treat ear infections, while Trimethoprim is commonly given to treat urinary tract infections caused by E.coli.
How long do antibiotics take to work?
Although antibiotics start doing their work straight away, you might not feel any benefit for a few days. Usually, your symptoms will start to improve in one to three days.
Once you start feeling better, you might be tempted to stop taking your antibiotics early, but it’s important to carry on until the end of the course. This is because there may be some bacteria remaining. If you don’t finish the antibiotics, your infection could come back – and be stronger and antibiotic-resistant.
European Commissioner for Health
Antibiotic resistance bacteria
The more antibiotics that are prescribed inappropriately, the more likely resistance is to develop.
A common misconception is that it’s the individual who becomes resistant to antibiotics. In fact, it’s the bacteria that adapts and develops resistance, rendering certain antibiotics useless.
Misuse and overuse of antibiotics is the biggest cause of antibiotic resistance and the rise of the so-called superbugs – illnesses that no longer respond to treatment and are now potentially deadly. These superbugs emerge when bacteria have not been properly treated with antibiotics and have learnt to become resistant; certain strains of tuberculosis and pneumonia have already developed resistance so can’t be treated easily, if at all.
Antibiotics are no longer routinely used to treat infections because:
- many infections are caused by viruses, so antibiotics are not effective
- antibiotics are often unlikely to speed up the healing process and can cause side effects
- the more antibiotics are used to treat trivial conditions, the more likely they are to become ineffective for treating more serious conditions
Where is antibiotics resistance a problem?
Antibiotic resistance is rising to dangerously high levels in all parts of the world. New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases. A growing list of infections – such as pneumonia, tuberculosis and blood poisoning – are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.
Antibiotic resistance is an issue worldwide, but even moreso in countries that have a relaxed approach to administering antibiotics.
In Thailand, for example, antibiotics are “widely available and inappropriately sold and given by grocery stores and retail shops” according to a 2019 study published by the Journal of the Medical Association of Thailand.
The inevitable affect, the researchers note, is that antibiotic-resistant bacteria are commonly and freely circulating through the population, meaning some illnesses are no longer treatable. Read more about potential issues if you are buying antibiotics in Southeast Asian countries.
The situation is similar in the UAE, where prescription-required medicines are routinely sold without prescriptions.
In America, it’s estimated that 35,000 people die from drug-resistant infections every year, while in Europe, it’s estimated that measures to tackle antibiotic resistance could prevent 27,000 deaths and save €1.4 billion per year.
Antibiotics were prescribed for COVID-19 at the start of the pandemic when there was little proven treatment for the disease. But they are no longer used as a COVID-19 treatment since we can now be sure it is a virus, not a bacterial infection.
However, a person might develop a bacterial infection as a complication of COVID-19 and in this case they might be prescribed antibiotics.
The COVID-19 vaccine and antibiotics do two completely different things. The vaccine helps your body’s immune system to kill the virus, while antibiotics fight bacterial infections. So having the vaccine shouldn’t affect the infection you’re taking antibiotics for, and the antibiotics shouldn’t affect the vaccine.
The World Health Organisation (WHO) is taking this issue very seriously: “Where antibiotics can be bought for human or animal use without a prescription, the emergence and spread of resistance is made worse,” it says.
The WHO also warns that, without urgent action, the world is heading for a “post-antibiotic era, in which common infections and minor injuries can once again kill.”
While there are some new antibiotics in development, none of them are expected to be effective against the most dangerous forms of antibiotic-resistant bacteria.
Given the ease and frequency with which people now travel, antibiotic resistance is a global problem, requiring efforts from all nations and many sectors.
Even if you live in a country where antibiotics are available without a prescription, and you think your self-diagnosis is accurate, you could do more harm than good by buying them over the counter. Antibiotics could interfere with other medicines you might be taking, or even damage your organs.
Dr Diab Maaruf Kurdi
Head of pharmacy at Burjeel Hospital in the UAE
Being prescribed a course of antibiotics by a medical professional is the first step, but there’s more that needs to be considered for antibiotics to work effectively.
You must follow the instructions and finish the course even if you’re feeling better. It’s also important to note whether the medicine should be taken before or after food, or with water. Never share antibiotics and do not accept them if a pharmacist offers them without a prescription.
According to WHO, to prevent and control the spread of antibiotic resistance, individuals can:
- Only use antibiotics when prescribed by a certified health professional.
- Never demand antibiotics if your health worker says you don’t need them.
- Always follow your health worker’s advice when using antibiotics.
- Never share or use leftover antibiotics.
- Prevent infections by regularly washing hands, preparing food hygienically, avoiding close contact with sick people, practising safer sex, and keeping vaccinations up to date.
- Prepare food hygienically, following the WHO Five Keys to Safer Food (keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, use safe water and raw materials) and choose foods that have been produced without the use of antibiotics for growth promotion or disease prevention in healthy animals.