AMR- No more a past fear, but here!
By Eseosa Favour Iyagbaye; PANS, Nigeria
I never really grasped the entire concept of Antimicrobial Resistance (AMR) until I began working in a community pharmacy, as part of my experiential learning process. I mean, I understand in words how decrying it is that microbes are now waging war and developing artillery against drugs once used to defeat them. Although an adroit scientist would understand the role of evolution in this, what makes this crucial, is how subtly, the menace of antimicrobial resistance has taken over the realm of health with respect to infections and their therapy. Moreover, the World Health Organization has described it as a serious threat no longer a prediction for the future, but one that is happening right now in every region of the world and that had the potential to affect anyone, of any age, and in any country.
Within my circle of experience, I have witnessed not just the aftermath of antimicrobial resistance, but its causes as well. Take a close look at Mrs A, a woman in her mid or late 50s, who comes by the pharmacy to refill prescriptions and get drugs for the non-communicable diseases she obviously deals with – hypertension, diabetes, osteoarthritis, etc. Mrs A is much uninformed or rather unyielding when it comes to medication use. Upon receiving her medication (following professional intervention by the doctor and pharmacist), Mrs A with so much determination insists for not just one but several antibiotics to be added to her drugs. Why? Because she believes that antibiotics ‘cleanse her system’. Well, in summary, it took so much effort counselling and convincing her that there was no need of them and that they could instead, lead to complications aside resistance due to interactions with her current medications.
That was just one in thousands of scenarios regarding the struggle of controlling antibiotics use and curbing resistance. Many persons, especially in this part of the world, harbour strange concepts pertaining to antibiotics and perceive them like a stone to kill several birds. Hence, one of the causes of AMR is ignorance, and non-compliance on the part of patients. I am quite certain how hard, health professionals have to deal with cases of patients failing to comply strictly with rational use of their medication. Well, these all result in the obvious damage caused by AMR.
In simple terms, antimicrobial resistance refers to a situation whereby microbes (bacteria, fungi, and even viruses) who were once susceptible to certain drugs (or antibiotics), begin to devise defensive mechanisms against such drugs, rendering the drugs futile in treating /curing infections once effective against the microbes. In other words, if Mr B had a similar bacterial infection he once cured using amoxicillin, AMR will result in him becoming unresponsive to the same drug (and for the same infection). Imagine millions of cases as this? It is certain that if this is left unhandled, we will totally run out of effective antibiotics. Actually, we are!
Again, within my little experience, I have witnessed patients switching from one antimicrobial drug to another, the reason being that they have become unresponsive to previous ones. Well, who bears the blame? Surely not just the patients. For a fact, ignorance and non-compliance by patients take a relatively small percentage with respect to causes of AMR. The increasing availability and inadequate control of antimicrobial drugs is a key contributor, as people access them over the counter without caution, and worse still, from illegal drug markets – predisposing them to drug misuse. Also, poor waste management systems by pharmaceutical industries who manufacture these drugs is a contributor. This releases drug products to aquatic systems without proper treatment, leaving microorganisms to continually come in contact with antimicrobial agents and develop resistant mechanisms. Consequently, it creates a circle of emerging generations of resistant microbes, hence untreatable infections!
Well, the good news is that all hope is not lost regarding antimicrobial resistance. It can be put to an end but requires a great effort from manufacturers, health professionals, patients, policy makers and regulators. It begins with me in my pharmacy, enlightening more people concerning AMR, its dangers and prevention. You come in the picture too. You can join in surmounting this AMR threat, by always seeking advice from qualified health professionals when it comes to using antimicrobial drugs, and of course, adhering to such advice. Furthermore, instead of relying on antibiotics for any and every infection, your best bet is to practice good hygiene always. The saying, ‘prevention is better than cure’ is not just a saying!
Thousands of infections are emerging which are caused by antibiotic-resistant bacteria, which have resulted in thousands of deaths. Together, we can ensure no more victims are added!