Use of antibiotics without prescription a growing problem

Published : 16 Jan 2020 08:59 PM | Updated : 07 Sep 2020 06:59 PM

It is heartening to learn that the government has warned the pharmacies of legal actions if they continue selling antibiotics without prescription. Of late in a public notice the Directorate General of Drug Administration (DGDA) issued a set of directives for the medicine sellers and advice for the antibiotics users.

Overuse of antibiotics without proper medical supervision is threatening lives in Bangladesh. Antibiotics are sold without prescription almost everywhere, and people use them often for any common malady, even cold and viral fevers. 

Such careless use of antibiotics, coupled with the common practice of dropping out of prescribed courses, is giving rise to antibiotic-resistant infections. Researchers fear that if such wrongful practice goes unabated, one day these antibiotics will not work anymore as the  intake of inadequate amount of antibiotics affects vital internal organs like kidney and liver and make human beings vulnerable to various diseases.  Hence, authorities concerned should imply a range of actions to stop the misuse of antibiotics and ban the sales of these drugs at pharmacies without prescription.

Bacteria-fighting drugs known as antibiotics help control and destroy many of the harmful organisms that make people sick. But overuse and misuse of antibiotics prompt some strains of bacteria to make a small change in their DNA and become antibiotic-resistant “superbugs”. Globally, superbugs are responsible for seven lakh deaths each year; the number could be more than 10 million by 2050 if things go unchecked, according to WHO.

Emphasizing the need for ensuring the proper  use of antibiotics, 

doctors need to evaluate the effectiveness of their 

treatment and antibiotics must be prescribed only if unavoidable

Antibiotic resistance is a worldwide problem that is increasing at varying rates in different regions. Countries  with  the  most  reserved  antibiotic-prescribing  patterns  have  relatively  lower  rates  of antibiotics  resistance. Overuse  of  antibiotics has often been linked with increased  organism resistance for  example,  most  cases  of  acute  bacterial rhino-sinusitis  (RS)  are  preceded  by  viral  infection, further  complicating  the  distinction.  The  most common  pathogens  isolated  from infected  maxillary sinuses  in  adults  are  Streptococcus  pneumoniae, Haemophilus  influenzae,  and  Moraxella catarrhalis.

 Bacterial  RS,  which  is  adequately  treated  by antibiotics, is suspected when symptoms worsen after five  days  or  persist  for  longer  than  10  days. Symptoms  of  less  than  10  days  of  duration  should generally  be  presumed  to  be  viral  acute  RS,  or common  cold,  which  is  normally  self-limiting  and does not require antibiotic use. In some countries, it is possible to buy antibiotics from  pharmacies  without  a  prescription  from  a physician  despite regulations. 

Antibiotics are not sold without prescriptions in developed countries. But in Bangladesh, one can just go to a pharmacy and get whatever one wants. Though there is no national-level statistics on the use of antibiotics in the country, researchers based on surveys address the situation as dire.

In most cases, antibiotics are used randomly in the case of treating pneumonia in children. There are different types of pneumonia among the children but paediatricians prescribe antibiotics of the same dose to all patients without categorising their type of pneumonia. Moreover, physicians are even prescribing them high dose of antibiotics without any necessary test.

Prescribing high power antibiotic at the beginning of any disease is a crime. According to WHO, due to antibiotic resistance in people, over 7.5 lakh people die every year and the number will rise to 10 lakh by 2050 as common infections and minor injuries are claiming lives, raising a concern in the post-antibiotic era. Emphasizing the need for ensuring the proper use of antibiotics, doctors need to evaluate the effectiveness of their treatment and antibiotics must be prescribed only if unavoidable.

Reports show that 55.7 per cent people in the capital have become resistant to antibiotics. This is indeed an antibiotic resistance catastrophe as a result of their excessive use. 

In order to limit it, a regulatory system should be introduced.  If we are unable to stop the practice, at one point all the antibiotics in the world will become useless, and bacteria and disease will become rampant. That is why it is very important that we tackle this issue as soon as possible. The fight against growing ineffectiveness of antibiotics, which is called anti-microbial resistance (AMR), requires a multi-sectoral approach.

The threat of antibiotic resistance is as great as that from climate change and should be given as much attention from politicians and the public. Efforts to combat the problem of common illnesses becoming untreatable by antibiotic medicines should be coordinated at a worldwide level in a similar way as the Intergovernmental Panel on Climate Change, the body of scientists set up in 1988 to tackle global warming. 

Sayeed  Hossain Shuvro is  Editorial Assistant,  Bangladesh Post