Ineffective antibiotics

ByRao Tashfain

Banker with an interest in international affairs


July 28, 2023

Ineffective antibiotics

Rao Tashfain talks about a serious problem

Ineffective antibiotics – The ineffectivity of antibiotics has become a serious factor in the medicinal annals of Pakistan and many sources dealing with healthcare are vociferously bringing this issue to fore. This fact is challenging the very basis of advancement in scientific approach that led to miraculous discoveries that revolutionised the way human race lived its life. The milestone was achieved when penicillin was discovered proving very capable in fighting external bodies making inroads into human body. Antibiotics was a novel way of treating the unhealthy affects of foreign bodies penetrating in human body through inducting bodies of same bacteria with chemical instruction to act friendly to human body and annihilate the enemy bodies. For the first time in the long history of human evolution this unique method of treatment swayed the balance in favour of humans and provided them with necessary wherewithal to stand up to fatal effects of bacterial infection.

The antibiotics were consequently fine-tuned and they were categorised as a large formation termed as antimicrobials, which includes medications to fight microorganisms such as bacteria, fungi and parasites. The large-scale production of antibiotics took place during the Second World War and it became instrumental in saving hundreds of thousands of human lives. The rise of antibiotics saw around a hundred different kinds of antibiotics being processed and used. Medicinal science categorises antibiotics on their mechanism of action, chemical structure and spectrum of activity. The development of this treatment system is such that most antibiotics target bacterial functions or growth processes.

Currently health care is heavily reliant on antibiotics as a common treatment of common bacterial infections, including strep throat, tuberculosis, urinary tract infections, and some sexually transmitted infections. Antibiotics also provide competent assistance to patients with acute immune systems disorders due to cancer treatment or major surgery. Scientists were always conscious of the level of resistance that bacterial substances were expected to launch against the pervasive tide of antibiotics. The resistance has accordingly been experienced and often reflects evolutionary processes that take place during antibiotic therapy. The antibiotic treatment may encounter bacterial strains with physiologically or genetically enhanced capacity to survive high doses of antibiotics.

They emphasise that what is needed in the country like Pakistan is childhood vaccination, clean drinking water and improved hygiene practices instead of indiscriminate use of antibiotics. It is often reported that currently patients, particularly children suffering from Salmonella Typhi bacteria that has caused typhoid fever are not responding to antibiotics. In many cases based upon the condition, symptoms and clinical diagnosis the patient was given Ceftriaxone, an intravenous antibiotic but showed no improvement. As a last resort the doctors then administered the stronger Meropeneme intravenously revealing the weak affectivity of antibiotics.

This difficulty reveals that the extensively drug-resistant (XDR) typhoid and the current antimicrobials had become ineffective. Multidrug-resistant (MDR) typhoid has been seen in Pakistan and analysis revealed a declining trend of MDR typhoid in south Asia, except for Pakistan, where XDR S.Typhi emerged in 2016 and rapidly replaced less-resistant strains. The reason why antibiotics are losing their punch against some types of bacteria is the indiscriminate use of antibiotics that health practitioners prescribe to provide immediate relief. Another big problem is self-medication by people. However, viruses, which are also small germs like bacteria, are causing bacteria-like infections, like a cold or the flu and have the potential of metamorphosing into superbugs.

Many researchers have pointed out that the indiscriminate use of antibiotics to be causing new drug-resistant superbugs. From 20 per cent in 1992, the resistance was found to have increased to around 50 per cent in recent years. The stubborn bacteria are now resistant to antibiotics like ampicillin, chloramphenicol, co-trimoxazole as well as fluoroquinolone or ciprofloxacin and ofloxacin. The situation is quite grim as the worry is not that the bacteria has spread but the real concern is the bacteria has mutated and become resistant to the drug. Doctors point out that they are running out of new antibiotics to treat bacterial infections and Meropeneme is the last one that is very expensive one too. They emphasise that though the development of newer antibiotics is the need of the day but the rational use of the ones being used is more urgent.

The fact is that developing new drugs is challenging and antibiotics more so as this process is very intricate. It is also pointed out that antibiotics are not the most lucrative drugs to develop for pharmaceuticals as their utility is limited in the future due to the bacteria developing the ability to resist them. Plenty of finance goes into developing new drugs and since most of the funding is from the global north, they prefer to work on infections that concern them directly. It is obvious that the illnesses endemic in the low and middle-income countries in the South, particularly Pakistan, have poorer water quality and have warmer, more humid climates and spending on medicines related to them is not the priority of the global North.

Faced with strong resistance of bacteria, antibiotics are actually on the verge of facing an existential threat less than a century since they came into play. Antibiotics are consequently proving less potent owing to frequent use by humans. The spectre of antibiotics failing to treat bacterial diseases is fast staring researchers in the face. It is estimated that drug-resistant bacteria is causing seven hundred thousand deaths a year currently and is predicted to rocket up to millions in about a quarter of a century. International health agencies and governments of developed world are pouring billions of dollars to handle this looming threat.

It is quite obvious that like all living organisms bacteria too adapt and evolve according to the environment they breed into and exist. It is also very natural to find out that bacteria develop defenses against antibiotics and develop the capability to survive the onslaught of antibiotics. They are found not only to survive but are also found to be reproducing and spreading. The growth of drug-resistant bacteria is calculated to equal the development in antibiotic treatment.

Adding to the problem is the exorbitant use of antibiotics globally. It is often estimated that tens of billions of antibiotic doses are used for treatment in the world and unfortunately a great deal of them are prescribed to patients with viruses or other illnesses that do not respond to antibiotics. In countries like Pakistan the problem is confounded due to lack of effective control of using medication as antibiotics could be easily bought over the counter without a prescription from a doctor. The excessive use of antibiotics for curing animals actually contributes to the spread of resistant bacteria that are easily transmitted from animals to humans through the food chain and in more indirect ways.

Doctors and researchers have become increasingly conscious of the fast reducing effectiveness of antibiotics due to proliferation of bacterial strains, called superbugs that are resistant to multiple drugs or even to all drugs. Consequently, pneumonia and urinary tract infections are becoming far more difficult to treat as antibiotics most commonly used to treat urinary tract infections are now considered ineffective for more than half the patients in many parts of the world and forms of tuberculosis resistant to commonly used antibiotics are growing by the day. The financial toll of countering the resistance to antibiotics is considerable. The Weekender


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