Experts say up to one-third to half of antibiotic use was unnecessary.
EXPERTS and health stakeholders have expressed concern about the growing resistance to antibiotics and resultant rise of the so-called superbug.

This follows studies showing that more than 80% of South African doctors said patients pressurised them into prescribing antibiotics.

Antimicrobial product manager at Pharma Dynamics Annemarie Blackmore said if doctors prescribed antibiotics based on symptoms rather than a fool-proof diagnostic test, they could increase the spread of antibiotic resistance.

“One of the biggest culprits in the rapid spread of antimicrobial resistance is the incorrect use of antibiotics. Some patients start off by taking the antibiotics as prescribed, but as symptoms abate, they discontinue use halfway through the course, which leads to resistance. In some instances, antibiotics are also shared among family members, without them realising the implications.

“In winter, more people are likely to suffer from colds and flu. Many patients still believe that taking antibiotics is the right course of treatment for the common cold, but don’t realise that antibiotics have been designed to fight bacterial and not viral infections.”

The common cold is a viral infectious disease caused by more than 200 strains of which rhinoviruses are the most common. Many symptoms might be the same, such as coughing, sneezing, fever and inflammation, but bacteria and viruses are inherently two distinct organisms and therefore respond differently to medications.

If one was diagnosed with strep throat or tuberculosis, then antibiotics would be the right course of action, Blackmore said, but the common cold, flu and sore throat did not require antibiotics.

“Most colds and flu go away on their own after a few days of rest and adequate fluid intake, and there are plenty of over-the-counter medications that can be taken to relieve symptoms instead of resorting to antibiotics as a first-line treatment option.” The Centre for Disease Control Prevention said up to one-third to half of antibiotic use was unnecessary or inappropriate. Taking antibiotics for a viral infection would not cure the infection, neither keep people from getting sick. It could, instead, cause unnecessary and harmful side effects, it said.

Doctors and pharmacists had to educate their patients about the importance of antibiotics, a precious resource and needed to be treated as such. “If not used responsibly today, antibiotic resistance might in the future render many antibiotics null and void. And infections such as TB and septicaemia are once again killing people at alarming rates. Antibiotics need to be used as a last resort or else there will be nothing left in our armoury to fight communicable diseases,” she added.

The National Strategic Plan has meanwhile made plans to get the country back on track to eliminate the public health threat by 2030.

A study, conducted in Cape Town last year, found that the problem lay in clinics, where staff largely ignored guidelines on prescribing antibiotics. Almost one in five people who were given the medication did not need it, it found.

“Others are given incorrect doses or the wrong type of antibiotic or told to take the drugs for the wrong length of time. In a few cases people who needed antibiotics don’t get them,” reads an excerpt from the study conducted in the context of global concerns about antibiotic resistance caused by over-prescription. Pretoria doctor Mahloadi Rampedi said some clinics flouted procedure. “And this is both in public and private health facilities.” Antibiotics were an easy way out and therefore prescribed anyhow, anytime, he said.

“The inappropriate and irrational use of antibiotics has contributed significantly to the development of antibiotic resistance“ a report, published in the South African Medical Journal said.

There was a global fear that without intervention the 700000 deaths would increase to 10million by 2050.

“In a post-antibiotic era infections will become untreatable.

Antibiotic resistance in a patient is evident for one month following an antibiotic course and can last for up to 12 months.”

Rampedi said the country needed to go back to basics, and teach society and health care “the fine art of prevention”, which was more cost-effective, less problematic and very basic”.