Misuse and abuse of antibiotics is a major public health problem in many countries around the world.
Their rational use, according to the definition of the World Health Organization (WHO), means the use of the right medicine, for the right indication, in the right dose over a certain period of time.
However, many patients, as well as doctors and pharmacists, do not adhere to this even today, which has resulted in the increasing spread of antibiotic resistance (AMR), one of the greatest threats to public health in the 21st century, writes Factor.
Drug-resistant bacteria
Antibiotic resistance occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial agents.
As a result of drug resistance, antibiotics and other antimicrobial agents become ineffective and infections become difficult or impossible to treat, increasing the risk of severe disease, its spread and death.
According to research results, in 2019 there were close to 1.27 million deaths caused by drug-resistant bacteria.
Among the most common causes of death are multi-resistant bacteria: Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa.
At the last two congresses of the World Pharmaceutical Organization (FIP), last year in South Africa, and this year in Denmark, antibiotic resistance was one of the main topics.
Until a few years ago, even in Bosnia and Herzegovina, patients could “on their own” go to the pharmacy and buy an antibiotic, without having to show a prescription from a doctor.
But that is in the past, says prim. M.Sc. ph. Marin Crnogorac, president of the Chamber of Masters of Pharmacy of the Federation of Bosnia and Herzegovina, stating that our country is not so bad compared to the countries of the European Union (EU) when it comes to the wrong use of antibiotics.
– The research showed that BiH ranked 13th on the list of 28 EU members when it comes to improper use of antibiotics. France and Spain are also behind us – says the Montenegrin on the occasion of the International Antibiotic Resistance Week.
Doctors prescribed antibiotics when they should not
This year’s WHO theme for the International Antibiotic Resistance Week is – “Act now: Protect our present, secure our future”.
– Many countries in the world such as the United States of America (USA), China, Germany have a very pronounced problem of antibiotic resistance, which creates a huge problem in healthcare, because certain antibiotics lose their effectiveness in the fight against diseases. As far as BiH is concerned, it used to be a common phenomenon in our country, which has persisted in some places even today, that viral diseases were treated with antibiotics, so when doctors did not know what to do, they ended up prescribing an antibiotic, because doing an antibiogram for each patient is an expensive investment – says Crnogorac.
He notes that the most pronounced problem in our country is the improper use of antibiotics.
– Many people take an antibiotic for three or four days, and then as soon as they feel better, they stop taking the medicine. In a large number of cases, these are only healed, not cured, which results in the recurrence of bacterial inflammation. If something like that happens several times, the antibiotic no longer works for them – explains Crnogorac.
The problem of the wrong use of antibiotics is especially pronounced during the season of colds, flu, and now also the COVID-19 disease.
– It is very important to finally understand that antibiotics cannot treat viral diseases, including COVID-19. We had a problem during the coronavirus pandemic when doctors started giving patients antibiotics. Most often, it was about the drug azithromycin with the generic name, which turned out to be completely useless in the treatment of COVID-19, because it is an antimicrobial, not an antiviral drug. However, some doctors, in order to remove responsibility from themselves, prescribed it most often at the insistence of patients. Now that COVID-19 is no longer as deadly as it was, no type of antibiotic should be prescribed in its treatment, which also applies to seasonal flu and colds. The antibiotic is exclusively prescribed for inflammation caused by bacteria – said Crnogorac.
