Spotlight on Antibiotic Abuse

The overuse and misuse of antibiotics has caused some simple bacteria to become drug resistant superbugs, that cause serious and even life-threatening disease.

It might not seem like it, but one of the most important health challenges of the 21st century is something we’ve been taught is our best ally to getting better. Antibiotic overuse has left a detrimental impact on society and everyone from pharmacists to physicians say, time has already run out on preventing this catastrophe.

A look at a joint report by the UN, World Health Organization and World Organization for Animal Health is enough to paint the dire picture. It says by 2050, 10 million deaths could be caused by drug resistant diseases.

Dr. Ryan Ramdass is a Specialist Physicians at Busamed Gateway Private Hospital with interests in diabetes and antimicrobial stewardship. He says radical change needs to made to the mentality around antibiotics because in the long run, we’re empowering even simple bacteria to become superbugs.

“CRE are strains of bacteria that are resistant to an antibiotic class used to treat severe infections. We call it the Superbug because there’s virtually nothing that can stop if from causing infections in your lungs, bladder and even skin. Superbugs can also spread and share their antibiotic-resistant qualities with the healthy bacteria in your body.”

Dr Ramdass says it’s not a problem that’s going to go away and effectively, we’re out of new antibiotics to try.

“What’s happened in the industry is that we have an uncertainty index whereby a GP is either comfortable in taking a paced approach and deescalates treatment when appropriate or is uncomfortable with not knowing what infection a patient has and thus prescribes a higher class antibiotic as a ‘catchall’ option. The problem with the ‘catchall’ approach is the resistance bacteria can form to the treatment which compounds the problem and compromises the patient’s immune system further.”

This is why Dr. Ramdass is part of an Anti-microbial stewardship programme. It’s a multi-disciplinary approach to prescribing antibiotics and there is a chapter in KwaZulu-Natal where he is based. A committee gathers to weigh in on the merits of administered powerful antibiotics to a patient. This collective think helps to protect the patient in the long run. “The stewards include clinical pharmacists, biochemists, physicians, nursing management and so on.”

Avishkaar Rampearie, Busamed Group Pharmacy Practice Manager says this type of approach is suitable taken because rational antibiotic dosing needs the buy-in from each role player in the patient’s treatment path.

“New antibiotics are not developed with the kind of frequency that would allow for us to stay ahead of bacterial evolution and this is why we need to support from within the medical industry first, to stop the over prescription of antibiotics to patients.”

Mr. Rampearie says while antibiotics are an innovative therapy, the management of it has cascading consequences on quality of life. “Without it (antibiotics) society might not have even made it to the 21st century. But there are simple infections that we’re battling to combat, these days, with the first and second classes of common antibiotics and that’s cause for concern.”

Mr. Rampeari says the Covid-19 pandemic revealed that basic personal protection is an excellent start. “What we noticed is that with the mandated wearing of masks, sanitising of hands in public areas and education on cross-infection from touching the eyes, nose and mouth, the typical spikes of influenza had significantly dropped. That’s proof-positive that personal hygiene helps to curb community infections.

Both Dr. Ramdass and Mr. Rampearie agree that without a commitment from the industry to be stewards of responsible antibiotic dispensing, there can be no sustainable fix. The U.S. Centres for Disease Control and Prevention estimates that approximately 2.8 million people worldwide are presently infected with antibiotic-resistant bacteria, accounting for almost a million deaths around the globe.