If the present practise of antibiotics excessive use and misuse persist without urgent check from governments, healthcare community and industry, there are indications that the outcomes might become overwhelmingly unbearable for the global community, as experts have warned of a looming epidemic of antimicrobial resistance (AMR), which is expected to claim 10 million lives annually from 2050, as estimated by the UN.
Aside the rising mortality burden, antibiotics overuse is also capable of making minor infections become life- threatening, serious infections becoming impossible to treat, and many routine medical procedures could become too risky to perform, the medical practitioners warned.
The World Health Organisation (WHO) defines AMR as the ability of a microorganism such as bacteria, viruses, or parasites to prevent antibiotics from working against it. This makes standard treatments become ineffective; infections persist and may spread to others. AMR is a growing global public health problem that threatens the effective treatment of a number of life-threating infections caused by bacteria, parasites, viruses and fungi that makes treatment of patients difficult, costly and even impossible.
The experts, including Professor Oyinlola Omoniyi Oduyebo; Prof. Kennedy Tamunoimiegbam Wariso, and Dr Kodjo Soroh, medical director, West Africa Pfizer, made their submissions at the Pfizer virtual media roundtable on antimicrobial stewardship, held on Tuesday.
Decrying the deteriorating condition of antibiotics use in Nigeria, Prof. Wariso said over 46 per cent of Nigerians abuse antibiotics, which is responsible for the surge in AMR, with about 62 to 71 per cent of under-five Nigerian children exposed to antibiotics in various ways. He further lamented that despite this huge burden of AMR in the country, there are no concerted efforts to address the event.
Wariso, who is a microbiologist, from the University of Port Harcourt Teaching Hospital (UPTH), however advocated adherence to antimicrobial stewardship programme, which seeks optimal use of antimicrobials, improve patient outcomes, reduce AMR and healthcare associated infections, and save healthcare costs amongst others.
“With rates of AMR increasing worldwide, and very few new antibiotics being developed, existing antibiotics are becoming a limited resource. It is therefore essential that antibiotics only be prescribed – and that last-resort antibiotics are prescribed only when necessary. A robust pipeline of new antimicrobials is essential to restoring the balance against increasing rates of AMR.
“However, significant economic hurdles have made research and development in this area a challenge. No novel class of antibiotics has been launched for almost 40 years, and even when newly approved treatments come to market, they may be used sparingly to support good antimicrobial stewardship practices – making it difficult to recover the high cost associated with development. New reimbursement models that more fully reflect the complete value of antimicrobials are critical”, he remarked.
Dr Soroh, in his contribution asserted that AMR is one of the biggest threats to global health today and can affect anyone, of any age, in any country.
Corroborating the UN’s estimate on AMR for 2050, which is 10 million deaths, he argued that the prediction may be inevitable if no urgent steps are taken by all stakeholders to avert the looming tragedy. “Overuse of antibiotics is creating stronger germs. Some bacteria are already “resistant” to common antibiotics. When bacteria become resistant to antibiotics, it is often harder and more expensive to treat the infection. Losing the ability to treat serious bacterial infections is a major threat to public health.
“Currently, at least 700,000 people die each year due to drug-resistant diseases. More and more common diseases, including respiratory tract infections, sexually transmitted infections and urinary tract infections, are untreatable; lifesaving medical procedures are becoming much riskier, and our food systems are increasingly precarious”, he bemoaned.
Charting the way forward from the qugmire of AMR, Prof. Oduyebo, noted that the solution lies with understanding the magnitude of the challenge, as that will facilitate the development of different strategies to tackle it headlong. Speaking on antimicrobial stewardship, which she simply described as using antibiotics the right way, she stressed the need for hospitals to set up antimicrobial stewardship programmes and policies as guiding principles for their daily operations.
Oduyebo, a clinical microbiologist with the College of Medicine, Lagos University Teaching Hospital, LUTH, advocated the constitution of monitory personnel in each health facility, whose responsibility will be that of supervising of antibiotics prescription, as well as ensuring the existence of clear clinical and bacteriological diagnosis before the prescription of antibiotics.
For individuals, she charged them to “use antibiotics only when prescribed by a certified medical doctor, never demand an antibiotics if your doctor says you don’t need it, never share or use leftover antibiotics, prevent infection with regular hygiene”.
She also tasked policy makers on development of a robust national action plan on antibiotics use, improvement of surveillance on antibiotics resistant infections and strengthening of antimicrobials policies and programme.