By Dr. Osvaldo F. Teglia, Medical Specialist in Internal Medicine and Infectious Diseases, Professor at the Faculty of Biomedical Sciences of the Universidad Austral.
The global consequences of human behavior on population health are undeniable. Over the years, we have witnessed the spread of antibiotic resistance like wildfire through the uncontrolled dissemination of genes. Simultaneously, we have also seen how medical practice can influence it, exerting selective genetic pressure through the overuse of antimicrobials.
In 2008, during the course of an infection by the germ Klebsiella pneumoniaeiae In a Swedish patient admitted to a hospital in New Delhi, India, it was revealed that this germ was a producer of a new enzyme capable of inactivating most antibiotics through a degradation mechanism, even those belonging to a group considered, until then, to be the ideal antibiotics, called carbapenems.
New cases of patients were quickly detected in other locations in India, Pakistan, England, the United States, Canada, Japan, and Egypt, demonstrating not only the intensity of connectivity among people in today's world, but also the back-and-forth experienced by the genes that encode these resistance mechanisms.
Antibiotic resistance is becoming an increasingly serious threat to global health. If this problem is not reversed, international health organizations estimate that 300 million people will die prematurely in the next 35 years due to drug resistance. This also translates into a loss of economic output of between $60 and $100 trillion USD by 2050.
Antimicrobial resistance, by sometimes leaving few effective treatment options, can cause diseases that were previously easily controlled to become serious infections that are difficult to treat and life-threatening for patients.
This threat to public health is closely linked to the often excessive and irrational use of antibiotics. Recent studies indicate that 60% of antibiotics are prescribed on an outpatient basis, and most of these are for upper respiratory tract infections (of viral origin) that do not require antibiotics, only symptomatic control.
Fortunately, in the last five years, multiple effective drugs against resistant organisms have been developed. However, the availability of new
Antibiotics have shown resistance to some of them, which is a cause for particular concern.
Physicians bear a responsibility for controlling this problem, and we can achieve this through rational prescribing, firmly adhering to treatment guidelines. However, governments and public health organizations should also develop public policies and programs to control antimicrobial use. These policies should include not only standardizing antimicrobial treatments for the most prevalent infectious diseases in the community and institutions, but also ensuring that antimicrobials are dispensed exclusively with a prescription. Simultaneously, policies should be promoted to control infections, particularly in healthcare facilities, to prevent the transmission of multidrug-resistant organisms among patients and, from there, to the community; the development of new molecules should be encouraged through research; and continuing medical education should be prioritized.
And the public, eager for antibiotics, must understand that antibiotics are often not the best solution for their health problem. The fight against antibiotic resistance requires the commitment of all parties; only then will it cease to pose a serious threat.
Source: Telam
