War against infections — are we losing? | By Dr Muhammad Imran Khan


War against infections — are we losing?

PEEPING into the past, we find our forefathers treating their ailments according to their mythology. A century ago top three causes of casualties were infectious diseases. They used naturally occurring chemical compounds for the treatment of infections. Topical Iodine, Bromine and Mercury compounds were used to treat infected and gangrenous wounds. Many health-related issues were too cured without antibiotics. Different products from the herbal source were commonly used in practice. These products are even now considered alternatives to recent antibiotics. Herbal medicines have minimum contribution toward bacterial resistance toward these agents. Bloodletting was also a standard treatment for different ailments.

The discovery of antibiotics helped reduce mortalities and revolutionized treatments. Fatal pandemics like Black Death stayed halted after penicillin and derivatives use. Alexander Fleming, who discovered penicillin (world’s first antibiotic), forewarned that the inappropriate use of antibiotics could lead to anti-microbial resistance (AMR). He revealed that bacteria evolve when exposed to antibiotic drugs and eventually no longer respond to those medicines. The irrational use of antibiotics in recent years for trivial infections is resulting in a loss of effectiveness against serious diseases. As a result of drug resistance, antibiotics become ineffective. The spread of AMR bacteria from one species to other is making the situation more pathetic.

There is an increasing tide of concern about AMR. The spread of antibiotic-resistant bacteria means that standard treatments in more cases no longer work, infections are difficult or almost impossible to control, and the risk of spreading diseases to others increases. Unfortunately, resistance problems have already developed for antibiotics used routinely and those deemed “last resort” treatments to cure people when all else has failed.

Silently mushrooming havoc of Antimicrobial resistance (AMR) is threatening the resilience of health systems worldwide. According to a BBC report, Over 1.2 million people died worldwide in 2019 from infections caused by antibiotic-resistant bacteria. This is more than the annual death toll either from Malaria or AIDS. People are dying from common, previously treatable illnesses because the bacteria that cause them have become resistant to treatment. Poorer countries are worst affected, but antimicrobial resistance threatens everyone’s health. AMR weakens modern medicines, thus putting millions of lives at risk.

There are many factors responsible for AMR. In a country like ours, the unjustifiable use of antibacterial medicines in animals and humans is a significant cause. Food and companion animals act as reservoirs for antimicrobial-resistant bacteria. Research work around the globe expressed AMR at the intersection of multiple species in one health approach. Over-the-counter sales of antibiotics without expert opinion in humans have worsened the situation. Quackery and non-professional practices in veterinary and human health fields are also absurd. As there is no practice of observing the withdrawal period in food animals, residues affect human health after consuming meat, milk, and other such products. Most of our population is rural and closely engaged with animals.

AMR transmission is possible in this livestock production system, where there is frequent animal-human interaction. Using antimicrobials rationally is key to reducing AMR. To ensure that these drugs are used appropriately, we must ensure that veterinary and human health services are accessible and affordable for affected populations. Antibiotics should only be sold on prescription by professionals (Authorized by regulatory authorities) in both human and veterinary sectors. Professionals must have updated skills in preventive medicine (good animal husbandry, efficiency in biosecurity and vaccinology).

The benefits of preventive measures must appeal to stakeholders so that they are willing to adopt them. Antibiotics should be developed separately for exclusive use in animals having a minimum residual effect. We need a deep dive right now to save our future generations. Innovative antibiotics should be developed with minimum resistance. Rational use of antibiotics can be made to avoid the situation. Monitoring and regulatory authorities can play a crucial role in curbing the negative impact of antibiotics. We can alter the factors mentioned above positively.

—The writer is working at Department of Veterinary Medicines, Faculty of Veterinary and Animal Sciences, PMAS Arid Agriculture University Rawalpindi.

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