Understand the use of antibiotics, combat antimicrobial resistance together
Published on: Tuesday, November 22, 2022
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Image credit: https://www.paho.org/en/campaigns/world-antimicrobial-awareness-week-2022
It's common that most of us think of antibiotics as some sort of a magic pill, especially when it comes to treating any infectious diseases. Have a cold? Let's get you antibiotics. Got an ear infection? Let's use up the antibiotics we have left on the shelf. 

Besides, most people also think they don't need to finish their medicines once they are healed/notice improvement in symptoms but that is certainly not true. Particularly for antibiotics prescription, your doctor would always instruct you to finish the course of treatment; whether it is five days, one week or sometimes even up to a month.

This is to ensure you’re properly treated as well as to prevent the occurrence of antimicrobial resistance which is seen as a growing problem in most Malaysian hospital settings these days.

Thus, in conjunction with World Antimicrobial Awareness Week, we wish to shed light on what you need to know about antibiotics that can help you better understand the use of antibiotics in order to combat antimicrobial resistance together.

What are antibiotics?

Antibiotics are essentially medicines that are designed to fight infections caused by bacteria in humans and animals either by killing the bacteria or stopping them from growing and multiplying. 

Before bacteria can multiply and cause infection, our immune system will usually react and fend off the infection, killing the bacteria from invading our body. However, sometimes the number of harmful bacteria may be too abundant for the immune system to handle and this is where antibiotics would be useful. 

Antibiotics come in a wide range of classes with different indications and side effects profiles. For example:

-  Penicillins (ie: penicillin, flucloxacillin, amoxicillin) that are widely used for a variety of infections such as skin infections, urinary tract infections

- Cephalosporins (ie: Cefuroxime, Cephalexin) indicated for more serious infections such as septicaemia and meningitis

- Aminoglycosides (ie: Gentamicin, Neomycin) which are used specifically in hospitals only to treat very serious illnesses such as septicaemia. 

- Tetracyclines (ie: Tetracycline, doxycycline) that are commonly used to treat acne and skin condition but are also effective for the treatment of other wide range of infections

- Macrolides (ie: Azithromycin, erythromycin) that are effective in lung and chest infections as well as an alternative treatment for patients with penicillin allergy or to treat penicillin-resistant strains of bacteria.

Antibiotics can be taken by mouth as liquids, tablets or capsules, or they can also be given in the form of injections which are typically indicated for patients admitted in the hospital due to a severe infection. Besides, we can also find antibiotics as creams, ointments or lotions to apply to the skin or to the eye to treat infections.

It is also worth noting that antibiotics are ONLY useful to treat bacterial infections and NOT EFFECTIVE against viruses such as common cold/flu, most sore throats, most sinus infections or fungi such as thrush in the mouth or vagina or fungal infections on the skin.

Inappropriate and irrational use of antibiotics will thus lead to antibiotic resistance.

What is antibiotic resistance?

Antibiotic resistance happens when germs no longer respond as they should to the given antibiotic. In other words, it is when antibiotics are no longer effective to treat the infections. Resistance to antibiotics occurs when bacteria alter their habits that render antibiotics to lose their ability to kill or stop the bacteria from developing. This is so due to the inappropriate prescription of antibiotics by healthcare providers or patients' tendency to self-prescribe due to the lack of awareness. As a result, infections are harder to treat and this indirectly causes higher medical costs, prolonged hospital stays and even increased mortality.

As resistance towards antibiotics continues being a public health concern, a greater need for alternative treatments arises. However, even if new medicines were to be developed and approved, without adequate patient education and behaviour changes, antibiotics resistance will remain a global health threat.

How can we prevent antibiotic resistance?

Preventing antibiotic resistance is just as simple as recognizing its indication and following your doctor’s instruction when you are prescribed with one. At the same time, it is important to follow some basic hygiene and health guidelines that can help prevent the spread of infection. 

Finish the course of ALL antibiotics prescribed for you, even when you feel better. Not finishing all of your antibiotics as instructed may result in the development of antibiotic resistance. This is because if an antibiotic is stopped mid-course, bacteria may be partially treated and not completely killed. Bacteria will then become resistant to that antibiotic and there would be a risk of re-infection.

Never self-prescribe your own antibiotic or get your antibiotics from local pharmacies without a prescription. Inappropriate use of antibiotics is the number one factor that causes antibiotic resistance and should be avoided at all costs. If you’re sick, it is encouraged that you visit your doctor so that effective treatment can be given to you.

Do not keep, consume or give your antibiotics to others. As mentioned, antibiotics is not a one man show and different antibiotics have different indications. Leftover medications should be discarded once the course of treatment is completed.

PS: Never dispose your medication by pouring it down the drain or flushing it down the toilet. This may harm the environment and again lead to bacterial resistance.

Always practice good hygiene such as washing your hands regularly and thoroughly to prevent the spread of infections or from being infected.

Get vaccinated according to your doctor’s appointment and evaluation and stay up to date.

Exercise regularly and develop a healthy, well-balanced diet to optimise your health.

Get 6-8 hours of sleep.