Antimicrobial Resistance: An ominous public health concern

The discovery of antibiotics in 1928 brought about a revolutionary change in the field of medicine. But due to its widespread use, bacteria are becoming resistant to antibiotics. Antibiotics are losing their effectiveness against diseases caused by infectious microbes. So, many people and animals are dying due to medical complications.

Antimicrobial Resistance (AMR), however, is a major global threat of increasing concern to human and animal health. It also has implications for food safety, food security, and the economic well-being of millions of farming households.

The World Health Organisation (WHO) recently warned that growing antimicrobial resistance is as dangerous as the coronavirus pandemic— threatening to reverse a century of medical progress.

A recent journal of the National Library of Medicine reveals that, by 2050, 10 million people will die every year worldwide due to antimicrobial resistance unless a global response to the problem of AMR is mounted.

There is undoubtedly a large clinical and public health burden associated with antimicrobial resistance, but it is challenging to quantify the associated excess morbidity and mortality.

Antibiotics are usually used to prevent bacterial attacks. Antibiotics also vary for different types of bacteria. If antibiotics are not used in the right amount and for a long enough time, the bacteria become stronger rather than destroyed. Then the antibiotic does not affect these bacteria. This condition is called antibiotic resistance.

Antimicrobial resistance is the ability of microorganisms to persist or grow in the presence of drugs designed to inhibit or kill them. These drugs, called antimicrobials, are used to treat infectious diseases caused by microorganisms such as bacteria, fungi, viruses, and protozoan parasites.

When microorganisms become resistant to antimicrobials, standard treatments are often ineffective; in some cases, no drugs provide effective therapy. Consequently, treatments fail. This increases illness and mortality in humans, animals, and plants. For agriculture, this causes production losses, damages livelihoods, and jeopardizes food security. Moreover, AMR can spread among hosts and the environment, and antimicrobial-resistant microorganisms contaminate the food chain.

Every time we use antimicrobials in people, animals, and plants, germs have a chance to acquire the ability to tolerate the treatments by becoming resistant, making the drugs less effective over time.

Bacteria are unicellular, microscopic, and microorganisms without a nucleus. It has about 15,000 species.

Not all bacteria are harmful, but many bacteria, even those living in our guts, are extremely beneficial. However, the harmful side of bacteria often catches our attention.

The disease, which was previously cured by antibiotics, is no longer cured by those antibiotics nowadays; rather continues to grow. The biggest reason for this is the excessive use of antibiotics recently. We take antibiotics for every ailment, from mild headaches to severe fever. In most cases, it works fine, but in one or two unique perspectives, some bacteria remain in the patient’s body that cannot be affected by antibiotics. Instead, they are adopting strategies to fight off antibiotics, and the new bacteria created by them have the same qualities.

Professor Md Sayedur Rahman, Department of Pharmacology, Bangabandhu Sheikh Mujib Medical University, who has been working on it for a long time, said, “Antibiotics specifically target bacteria and are used to treat bacterial infections. On the other hand, antimicrobials encompass a broader range of products that act on microbes in general. Microbes encompass different types of organisms: bacteria, fungi, viruses, protozoa.”

“Overuse of antibiotics causes bacteria to become antibiotic resistant. Most people in Bangladesh take antibiotics for any illness; it can be very harmful to our body day by day. New types of bacteria are emerging worldwide, but no new antibiotics are likely to be discovered in the next 5 to 7 years. So, I think we are going to face another pandemic”, he added.   

One of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) scientists said this problem is seen in many patients admitted to the hospital. Those who did not take any antibiotics even three months before admission to the hospital, but the bacteria in their body are multiple drugs resistant.

It means that even if the child is not taking antibiotics, the medicine is not working in their body due to the environment. That is, none of us is antibiotic resistant even children are not. Antimicrobial resistance is increasing at a rate several times higher than the rate at which new antibiotics are being developed. In the near future, even a slight sneezing-cough-fever may cause death to people. It takes 15 years to create an antibiotic and one year to develop bacterial resistance.

At some point, it will be seen that any medicine cannot damage the germs of the disease. Antimicrobial resistance in children may not have a genetic or hereditary cause. However, if antibiotics are used in animals’ bodies when we eat meat or vegetables or in the production of vegetables, it creates resistance that affects human bodies.

We eat fish, chicken, beef, etc., for protein, and antibiotics are used to save them. That is, people are risking their future for their protein.

An infected person or animal spreads antimicrobial-resistant bacteria inside their body by sneezing and coughing in the presence of others, and they also get the same incurable disease.

Buying and selling antibiotics without a doctor’s prescription is currently the main cause of antibiotic resistance. It must be closed. Packets of all antibiotic medicines should be re-coloured and kept separate from other medicines so that people can easily distinguish them.

Please don’t take the dose of antibiotics without the doctor’s advice, complete the dose and follow the rules. Antibiotics are unnecessary to treat these four diseases—minor fever, cold, cough, and diarrhea. So doctors should refrain from giving antibiotics in these four conditions.

There is no end to the contribution of antibiotics to the rapid recovery of disease and the increase of average life expectancy in humans and animals.

Antimicrobial resistance is a complex problem that requires a united multispectral approach. A proper health approach brings together multiple sectors and stakeholders engaged in human, terrestrial and aquatic animal and plant health, food and feed production, and the environment to communicate and work together in the design and implementation of programmes, policies, legislation, and research to attain better public health outcomes.

This terrible scourge can be prevented by increasing awareness and proper knowledge about taking medicine and its application. Learning about antibiotic resistance is indispensable. Say no to antibiotics without a doctor’s advice.

The writer is a development worker. She can be contacted at [email protected]