Antibiotic resistance (ABR) was initially observed in 1947, within only 20 years of the discovery of penicillin in 1928. Since the rise of antibiotics, overuse, misuse, over-the-counter use, and use of antibiotics in farming have been widespread.
Researchers assume antibiotic resistance to be the next great plague. Amidst tackling the rising rate of resistant infections and superbugs, which is already one of the most defining challenges of our time, irrational use of antibiotics owing to Covid-19 has further jeopardized the situation.
Patients around the world are being prescribed antibiotics like Doxycycline, Amoxicillin, or combination therapies, as it is very strenuous to determine whether a patient exhibiting symptoms of Covid-19 has an overlying bacterial infection or not.
But one should perceive the fact that an antibiotic is a drug that is only active against bacteria. SARS-Cov-2 originates from a virus. A prescribed antibiotic can only suppress secondary bacterial infection caused by the virus, but not the virus itself.
Misuse of particular antibiotics will make the bacteria immune to said antibiotic the next time around. The World Health Organization (WHO) has already discouraged the use of antibiotics to treat mild corona.
Bangladesh has always been a major contributor to ABR as many of our people like to play doctor. On April 25, 2019, the High Court ordered the government to take necessary measures to put a stop to the sale of drugs without prescriptions from registered doctors.
The National Drug Policy 2016 states that all 100 or more than 100-bed hospitals at government and private levels of the country must have their own “antibiotic user guidelines,” which must be regularly updated and followed during delivery of health care services. Subsequently “antibiotic user guidelines” will be formulated and implemented for all hospitals, to assure rational and safe use of antibiotics, but a poor regulatory regime has always been a drawback to implementing such laws.
A study suggests that people in our country have already become 50% resistant to common antibiotics like Ciprofloxacin, Gentamicin, Cefixime, and Azithromycin, which are used to treat wounds and various infections caused by a Pseudomonas bacteria. Azithromycin showed 100% ineffectiveness in treating wound and urine infections.
In our country, a combination of Ivermectin and Doxycycline has been widely used and statistically proven effective in mitigating Covid-19. People are administering many other antibiotics without prior guidance. While taking any antibiotic, completing the prescribed dosage regimen is essential to eradicate bacterial ability to survive exposure to similar antibiotics in the future. But if not followed accordingly, bacteria will eventually adapt to the antibiotic, thus exacerbating the condition.
Owing to the fact there is one physician per 1,000 people in Bangladesh, behavioural antecedents also act as a major factor in escalating ABR in our people. The intake of antibiotics based on previous experiences or on what others have experienced, taking antibiotics up to the point when the patient feels OK, not completing the entire treatment duration -- all these frivolous attitudes will end up engendering the rate of ABR among mass people.
It is difficult to gauge the precise impact of Covid-19 causing ABR in our people, but undoubtedly, it will aggravate the antibiotic resistance issue during pandemic and beyond.
However, to alleviate post-pandemic-ABR and put a stop to the rise of new superbugs, it is crucial that authorities allocate proper guidelines, and we remember to use antibiotics only when prescribed by health professionals.
Sumaiya Nawshin is a pharmacy student. She can be reached at [email protected].
