Professor Marc Mendelson warns of the public health consequences of the Cape water crisis.

Cape Town’s drought could fuel growing resistance to common antibiotics as more people are expected to become sick when normal hygiene practices are pushed aside in the name of saving water - resulting in more antibiotics being dispensed.

This is according to Professor Marc Mendelson, head of the infectious diseases division at the University of Cape Town.

“In drought situations, one usually sees an increase in the transmission of bacterial and viral infections through food and waterborne processes. Also if people wash their hands less, the worry is that we’ll begin to see more diarrhoeal disease in particular,” Mendelson said.

The World Health Organization (WHO) states that Antimicrobial Resistance (AMR) is the “ability of a micro-organism such as bacteria, viruses, and some parasites to stop an antimicrobial (antibiotics, antivirals and antimalarials) from working against it.”

The global health agency also says that germs’ resistance to antibiotics makes standard treatments ineffective and can make common infections harder and sometimes impossible to treat.

Experts warn that resistance is fuelled by the improper use of the drugs which allows resistant bacteria to develop and spread and that when there are no antibiotics left with the ability to kill bacteria, clinicians are left with few treatment options. Moreover, newer antibiotics are not being developed fast enough to outpace the increase in resistance.

Mendelson said the limited data available shows that “antibiotic resistance is a significant problem in South Africa, adding  “we clearly need to do more to tackle it.”

He said to date there have been no concrete reports of increases in diarrhoeal disease in the Western Cape since the drought while research from other countries has shown that droughts have the potential to make a serious impact on the development of drug-resistance.

But Mendelson cautioned that “just because we haven’t heard about it, it doesn’t mean it hasn’t happened”.

He said the concern is that more people than usual will come to clinics with diarrhoea and other infectious illnesses and be treated with antibiotics without health workers establishing whether the infection is bacterial or viral.

“The more you use antibiotics, the more you allow resistant bacteria to develop and then spread in communities,” he explained. “The vast majority of people don’t need antibiotics in these cases because diarrhoea diseases are driven by viruses to a large extent.”

Mendelson said in the absence of quick and easy ways to diagnose whether an infection is bacterial or viral, many clinicians often treat patients with antibiotics.

Meanwhile, drug resistance has been in the spotlight this week as WHO published its first report on AMR surveillance data on Monday. This included information on antibiotic resistance from 22 countries.

The report revealed high levels of antibiotic resistance in many countries including South Africa and estimated that at least half a million people had resistant infections across the included countries in the 2016/2017 reporting period. - Health-e News.

The Independent on Saturday