Unregulated antibiotic use could kill 10mln people by 2050

Antibiotic resistance is one of the world's deadliest health crises. Without concerted action, the annual death toll could reach 10 million by 2050 which is more than the number of deaths from cancer, cholera, measles and traffic accidents combined.

The cumulative impact on global economic output could reach $1 trillion by 2050. Hence, the Ministry of Health and Prevention (MoHP) is working on new legislations to end the dangerous consequences of the random intake of antibiotics.

Dr Amin Hussein Al Amiri, assistant undersecretary for Public Health Policy and Licences, chairman of the higher committee for Drug Alerting in the UAE, said the indiscriminate use of antibiotics leads to epidemics, unless intervention and radical solutions are found.

"I would like to point out that the new Federal Law on the 'Regulation of the Profession of Pharmacy' is extensively addressing the issue of medicines, which must be disposed only by prescription."

Dr Al Amiri stressed on the importance of rationalising use of antibiotics and avoiding the risks of misuse as this may increase the ability of the bacteria to resist antibiotics, leading to loss of effectiveness. He warned strongly against taking antibiotics without consulting a doctor, and not to dispose them without a prescription.

According to studies, although non-prescription sale of antibiotics is illegal in the GCC states, 68 per cent of pharmacies in Abu Dhabi, 78 per cent in Riyadh and 87 out of 88 pharmacies in Saudi Arabia sell them without a prescription.

Researchers have also found that poor hand-hygiene compliance in hospitals and the region's large population of migrant workers could have contributed to the spread of antibiotic-resistant bacteria.

"Many doctors think that starting a super strong antibiotic is necessary for patient betterment," he said, adding that physicians should do a risk assessment for patients, investigate and then prescribe.

Dr Laila Al Dabal, head of infectious diseases unit at Rashid Hospital, said: "Unfortunately, antibiotics are being prescribed wrongly by the physicians or under pressure from patients.

"Another common mistake is incomplete courses of antibiotics, so the patient might take two or three doses of antibiotics and as soon as she/he feels better, they stop the antibiotic without going back to the prescribing physician.

"This will obviously lead to the creation of drug resistance and there is a cumulative risk every time an antibiotic is used or prescribed inappropriately," she added.

Experts say that while physicians are prescribing antibiotics unnecessarily, patients are popping pills without the right prescriptions.

"Physicians are under pressure from patients. They feel that if they don't prescribe the antibiotic, they will be blamed if something goes wrong later," said Dr Ashraf ElHoufi, head of the hospital infection control committee at Dubai Hospital.

Aetna International, a global healthcare company has outlined effective strategies in a new white paper titled 'Antibiotic resistance: Toward better stewardship of a precious medical resource'.

According to the paper, the main causes of antimicrobial resistance (a broader category that also encompasses drug-resistant viruses, fungi and parasites) are misuse and over-prescription; the use of antibiotics in agriculture; a lack of research and an anaemic drug pipeline; and poor hygiene and sanitation.

Dr Mitesh Patel, medical director, Aetna International, said: "We strongly advocate action through proactive education, early intervention, data analysis and an emphasis on value-based care. The antibiotic resistance is a crisis that effects everyone globally and we need to address this issue now with a global, multifaceted strategic solution.

"Stemming the rising tide of antibiotic resistance will take a global, multi-pronged effort. The industry must become better stewards of the antibiotics we have today, while working to develop more antibiotics for tomorrow. A focus on harnessing big data will inform strategies that create better care for patients as well as significantly decreasing the financial cost from antimicrobial resistance," said Dr Patel.

55 per cent British doctors under pressure to prescribe antibiotics

A 2014 survey of 1,000 primary care doctors in the UK found that 55 per cent felt pressure, mainly from patients, to prescribe antibiotics, even if they were not sure whether it was necessary. This highlights the urgent need for a greater effort to educate individuals about the use of antibiotics.

A large proportion of the population mistakenly believe they should stop taking an antibiotic once they begin to feel better.

However, it is also imperative to tailor antibiotic stewardship strategies to individual countries. Each country will differ on a case by case basis, which means alternative strategies are needed to combat antibiotic resistance.

In order to succeed, an integrated, multi-sectorial antibacterial resistance strategy is needed.

The WHO Global Action Plan looks at ways to improve understanding of antimicrobial resistance, with methods such as increasing research to strengthen the current knowledge and evidence base. It also suggests reducing infection through effective sanitation and optimising the use of antimicrobial medicines in human and animal health.

WHO study finds who takes antibiotics in a proper way

A 12-country survey by the WHO in 2015 demonstrates the differences between countries when it comes to taking antibiotics. At least 75 per cent of respondents from Egypt, India, Mexico and Sudan reported taking an antibiotic within the last six months, compared with just 35 per cent of those from Barbados. Nearly 90 per cent of South Africans understand they should take the full course of antibiotic, compared with just 47 per cent of Chinese.

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Superbugs are real

Overprescription of antibiotics and its overuse in animals have caused growing drug resistance in humans, and are leading to serious health implications. The rise of superbugs is real. They cannot be treated with existing antibiotics and threaten the gains made in medicine. Millions could die every year for the lack of medicine. Concerted effort at the global front is required to tackle this problem.

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