In 1945 Alexander Fleming shared a Nobel Prize for his discovery of antibiotics. And even in those early days, he warned of the dangers of antibiotic misuse, as he did in his Nobel Lecture:
“There may be a danger, though, in underdosage. It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body.”
Decades later, the researchers behind a new study from Cambodia, where antibiotics are widely and easily available, say that Fleming’s fears are still being realized, all these decades later.
This study looked at what its authors called a “pervasive antibiotic misuse” of antibiotics for “mild” illnesses and for conditions for which such medications are utterly useless, like the cold virus. They found that, just as it happens in other countries, antibiotic misuse is the fault of patients and healthcare providers.
Bacterial Resistance In Cambodia
Previous studies of drug-resistant bacteria in Cambodia have delivered some frightening truths. In 48% of E. coli samples, for example, the swabs came back positive for resistant strains. More than 20% of S. aureus samples also showed some resistance.
What’s driving this? Inappropriate prescribing, say experts who have known about (and studied) this problem for years. A 2002 survey of Cambodian health clinics found that, in some facilities, every single patient is sent home with a prescription for at least one antibiotic with little to no information about proper dosage, how long to continue the medication or any warnings about possible interactions with other drugs.
Patient demand also factors in, say the study’s authors. Antibiotics are widely and commonly given to children, especially to treat respiratory infections, which are most often viral, and diarrhea, which most doctors treat only with fluid replacement. In many such cases the antibiotics are “prescribed” by the parents and purchased over-the-counter in pharmacies and food markets.
Also contributing to patient misuse is the presence of untrained pharmacy technicians. This study found untrained pharmacy attendants openly admitting to recommending antibiotics for concerns like colds, coughs and even headaches.
What’s The Answer to Antibiotic Abuse?
The authors of this study acknowledge the vicious cycle underlining the problem of antibiotic abuse in Cambodia. Patients who know little about how the medications work demand them and under-trained pharmacy techs and nurses provide them.
The authors of this study suggest a two-fold approach involving a crackdown on the part of doctors who over-prescribe and a public education effort to teach patients that antibiotics are sometimes unnecessary and, are often, ineffective.
Photo Credits: Pixabay users EmilianDanaila, Lenalensen, rmao0