Prudent Antibiotic Use

Antibiotics are among the prized discoveries of medical science. Rightly called miracle drugs, they have transformed once mortally feared bacterial infections into treatable medical conditions. They are so effective in curing infections that they are highly sought after worldwide. To cater to the growing needs, ways have been discovered to mass-produce and make them available at affordable rates. This has paved the way for them to be used excessively, even when less-powerful drugs could treat the condition without needing them. 

Unregulated use of antibiotics has raised serious health concerns globally, including in Nepal. The overuse and misuse of antibiotics are fuelling the rise of antibiotic-resistant bacteria. That means the germs, instead of being killed, continue to grow stronger. Bacteria are developing resistance to drugs faster than we are developing new drugs against them. Antibiotic resistance, where bacteria evolve to withstand antibiotics, is a growing global health crisis, putting many gains of modern medicine at risk. 

Drug-resistant pathogens kill almost 1.3 million people around the world each year and contribute to the deaths of nearly five million others, according to the UN, by making infections harder to treat and making other life-saving procedures and treatments riskier, such as surgery and cancer chemotherapy. Low- and middle-income countries face a disproportionate burden, with the highest rates of antibiotic-resistance-related deaths occurring in sub-Saharan Africa and 

South Asia. 

According to a recent news story carried by this daily, antimicrobial resistance (AMR) is slowly becoming a major health issue in Nepal, especially in the rural areas, where people still buy antibiotics directly from pharmacies without a doctor's prescription. While there is a law in place to regulate the distribution of antibiotics, enforcement remains weak, and many pharmacies continue to dispense antibiotics without asking for a prescription or checking the patient's medical history. This is happening despite pharmacists being prohibited from selling antibiotics without proper consultation. 

Another practice contributing to the crisis is the heavy use of antibiotics in livestock, especially those raised for meat. These animals are fed with the drugs not only for treatment, but also for their growth promotion. When people consume such meat, they are at risk of being exposed to drug-resistant bacteria that may already be present in the livestock. Doctors at the Tribhuvan University Teaching Hospital (TUTH) have, of late, been treating cases of multidrug-resistant (MDR) and extensively drug-resistant (XDR) organisms, which have become alarmingly common and frequent. The same applies to many other hospitals as well. 

A low-income country like ours cannot afford to turn a blind eye to this emerging crisis. A recently published report by the Centre for Global Development estimated that drug-resistant infections could lead to a $1.7 trillion reduction in economic output by 2050, much of it driven by lost productivity or the early deaths of family breadwinners. Without meaningful and urgent action to address the crisis, the effects of this death toll on the global economy could be staggering. 

The gravity of the problem calls for judicious use of antibiotics and strict implementation of antibiotic stewardship, a programme that ensures antibiotics are used responsibly, improving patient outcomes, reducing antibiotic resistance, and minimising unnecessary costs. Antimicrobial medicines are the cornerstone of modern medicine. Letting it get undermined is too costly to bear.