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The silent epidemic:  Antimicrobial resistance and our battle against it

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HAVE you ever noticed, why nowadays medicines take more time to cure your sore throat? Have you noticed that the effectiveness of medicines is decreasing these days? Have you paid heed that why your pus wounds are taking more time to be healed? Have you felt any abnormal change that stomach and intestine medicines act less efficiently to cure your diarrhea? Have you observed a suspicion that the medicines you used for common ailments are not as effective now as they were in the past?  All these things depict that the agents causing these problems have become stronger against our weapons that are the medicines which we used to kill them.

Specifically in the broad canvas of medicines, antibiotics are the ones that have become less effective over the period of time against these germs, mostly due to our irrational and imprudent use, thus causing antimicrobial resistance against antibiotics. The past worries of health experts have started to show its consequences now. In Pakistan too, doctors and health professionals have raised the alarm over the increasing resistance to even broad-spectrum antibiotics. Antimicrobial Resistance (AMR) is often referred to as a silent enemy, lurking in the shadows of modern medicine. Unlike visible threats, AMR does not announce its presence with a dramatic onset of symptoms or immediate consequences. AMR is now one of the three greatest threats to human health listed by the WHO.

Antibiotics getting resistant to harmful germs are just like an unsharpened knife which, due to overuse, gets blunt and loses its ability to cut things. Antimicrobial Resistance (AMR) is when bacteria, viruses or other microorganisms become strong enough to resist the medicines meant to kill them, making infections harder to treat. Antimicrobial resistance is a significantly emerging global health issue that threatens to reverse decades of medical progress. 1.27 million deaths per year are directly caused by bacterial AMR. Many instances of AMR may be discovered in Pakistan, where the problem is of particular concern to medical professionals due to the rise in drug-resistant strains of common diseases including typhoid and tuberculosis. In Sindh, there was an outbreak of highly drug-resistant typhoid in 2018. If no action is taken, AMR could cost the world’s economy USD 100 trillion by 2050. It’s a term that may not be familiar to everyone, but its implications affect us all.

Antimicrobial agents are basically our guided missiles or bullets such as antibiotics, antifungals, antivirals and antiparasitic have been instrumental in treating infections and saving lives for over a century. Some of the major causes of the slow and steady development of AMR are the overuse and misuse of antimicrobial drugs. Most of the people, when they get a mild fever or flu, go to a pharmacy and take these highly sensitive medicines called antibiotics by themselves without any doctor’s prescription.Their uncontrolled use in agriculture as growth promoters for livestock creates problems of resistance. The development of new antimicrobial drugs has slowed down significantly in recent years and the pipeline for new antibiotic discovery is dry. This means that existing drugs are relied upon more heavily, increasing the likelihood of resistance.

AMR has far-reaching consequences for individuals, healthcare systems and society at large. It can lead to longer hospital stays, increased treatment costs and higher mortality rates. As treatment becomes less effective, healthcare resources are strained and the risk of hospital-acquired infections rises. Inadequate hand-washing, improper food handling and lack of sanitation can lead to infections, prompting antibiotic use.

The effective control strategy for addressing AMR requires a multi-pronged approach. Implementing antimicrobial stewardship programs in healthcare facilities helps ensure the appropriate use of antimicrobial drugs. Educating the public on the responsible use of antibiotics and the consequences of AMR is crucial. Innovative approaches to combat AMR can help us tackle this silent pandemic more prudently. Developing vaccines for bacterial infections can prevent the need for antibiotics in the first place.

The most valuable future recommendations to overcome this looming monster are: International cooperation is essential to tackle AMR effectively. Governments, healthcare organizations and pharmaceutical companies must work together to develop and implement solutions. Stricter regulations on the use of antimicrobials in agriculture can help reduce their contribution to AMR.

In conclusion, antimicrobial resistance is a global threat that requires immediate attention and concerted efforts from all sectors of society. By understanding its causes, effects, control strategies and alternatives, we can work together to mitigate this crisis. However, to achieve this in future, it is essential that we act decisively and collaboratively now. The battle against AMR is one that we cannot afford to lose. Play your role positively and significantly in it according to your level and position in the global health army battling against it.

— The writer is DVM, MPhil Veterinary Medicine, RVMP, Rawalpind.

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