We have already discussed the scale of the problem in the articles on the antibiotic resistance pandemic. New data shows that nearly 1.3 million people died from an antibiotic-resistant bacterial infection in 2019, and that 4.5 million people died as a result. Additionally, antibiotic use in childhood is linked to a number of illnesses later on in life.
We also explained how bacteria becomes resistant to antibiotics. This means that the more antibiotics that we use, and the more resistant we become, the worse it gets. This means that we have to resort to last-resort antibiotics for common infections such as cystitis and pneumonia, gonorrhoea and meningitis. Some of these infections are untreatable. We also explained how this happens in animals whether they are pets or animals used as food.
READ | Part one: There’s another pandemic we should be focused on: Antibiotic-resistant infections
This article will discuss how antibiotics have been misused, misused, and how they are causing harm to our environment.
About one third to one fifth of all antibiotics that are administered to humans are used in the human body. Unnecessary. The majority of misuse occurs in primary care, where people are given antibiotics for viral infections like the common cold, ‘flu’, bronchitis, and diarrhoea or any number of aches and pains.
Antibiotics only work against bacterial infections, not viruses or non-specific symptoms – you can’t fit a square peg into a round hole. They can increase resistance and cause undesirable side effects if they are misused.
Part 2: Why fighting bacteria is a bad strategy| Part two: Why the ‘war’ against bacteria is the wrong strategy
The hospital prescribers are also responsible for prescribing antibiotics. unnecessary, often continuing antibiotics for too long, choosing the wrong antibiotic and not sending or acting on test results.
It is also important to choose the correct antibiotic. Doctors often use ‘broad spectrum’ antibiotics which do more You can cause harm to your bacterial ecosystem and can drive resistance in a broader range of bacteria than narrow spectrum antibiotics like good old — but far less ‘sexy’ — penicillin. These broad-spectrum antibiotics are more easily abused if the tests are not done correctly or sent to the wrong laboratory.
What’s behind this unnecessary prescribing? The answer is complicated. First, many prescribers do a great deal and understand the problem. Others may have different priorities, and continue to prescribe poorly.
Reasons driving unnecessary antibiotics include a desire to cover all the bases regardless of how unlikely a bacterial infection is, lack of understanding of the correct use of antibiotics and the damage they do, wanting to please the patient so they will come back in future (a particular issue in private health care), difficulty accessing healthcare so that the prescriber may feel they only have ‘one bite at the cherry’ (more common in the public sector) and sometimes due to social pressure, when patients insist on being given an antibiotic. A major incentive is that doctors have been paid based on how many prescriptions they wrote in countries like China (not South Africa).
South Africa has another social pressure: an antibiotic prescription is often seen in South Africa as proof of illness. I know of many instances where employers won’t believe that an employee is sick or allow sick time without them having antibiotics.
South Africa is also facing a second problem. It has an epidemic of infectious diseases.
Furthermore, we have a large population with immunosuppression — HIV, malnutrition, TB and other chronic illnesses — meaning that there is a huge burden of people presenting for medical care with non-bacterial illnesses. The more people who are sick, regardless of their reason, visit clinics, the more likely they will be prescribed an unnecessary antibiotic.
Access to safe sanitation and clean water can reduce the incidence of diarrhoea related to antibiotic-resistant diarrhoea by as much as 60%. O’Neill report. Maximizing vaccination coverage in order to prevent pneumonia would also significantly reduce antibiotic use use.
So reducing society’s problems that drive infections is an important part of the solution to tackling antibiotic resistance. But this is easier said than done in cash-strapped low- and middle-income countries like South Africa.
Antibiotics are equally misused and abused in animal health. Consider companion animals, such as your loveable pooch or Miss Tiddles. UnnecessaryUse of antibiotics in pets can lead to antibiotic resistant bacterial infections in just the same way as it plays out in humans, as animals too exist in symbiosis with bacteria.
People and their pets can also share bacteria through touch and pet care. So it’s in your best interest that Fifi Trixibelle only gets an antibiotic when she needs it!
Another major concern is animal protein production. There are many factors that lead to antibiotic misuse in chickens and other animals, including sheep, cows, pigs, and cattle. You will find responsible farmers and veterinarians working together in order to limit antibiotic misuse, just as doctors.
However, the animal protein production industry is often about fine margins. Therefore, it is difficult to get animals to market in the shortest amount of time at a decent weight and in optimal condition.
Antibiotics have been added to water and feed for decades to optimize and accelerate growth. Access to antibiotics in feed has historically been through a different Act of legislation in South Africa, which means that farmers can buy feed containing antibiotics over the counter and without a veterinarian’s prescription.
Regular use of antibiotics is also a common way to prevent infections in flocks and herds. Think about it; if you have 30,000 chickens in a shed, and a few start coughing, you’re not going to go chicken-to-chicken with a stethoscope and only treat those with signs of infection. To prevent infections, antibiotics are often given to animals in bulk.
We are talking about huge quantities. Some countries will allow up to 80% of all antibiotics bought to go into animals, primarily in Africa. food production.
How does using antibiotics inFood production animals affect humans? Again, antibiotics will cause antibiotic resistance in their gut bacteria. The sensitive ones have been mostly killed.
The spread of antibiotic resistant bacteria to the carcass can occur during slaughter. If good food hygiene is not practiced from farm-to fork, this bacteria could end up in your food. That’s why good kitchen hygiene is so important when handling animal protein, and indeed all types of food including vegetables and fruit too, as we’ll see shortly.
Vaccination is a common way to reduce the incidence of infections in food production animals. It is widely used in all food production systems. For example, the Norwegian salmon industry reduced antibiotic use in aquaculture to nearly zero by vaccination each individual farmed salmon. Click Here to see how it’s done.
Other infection prevention measures such as increasing space on farms, diet changes, and improving animal housing have all helped to reduce the need for antibiotics. Problem is that it requires financial commitment whereas antibiotics in feed are much cheaper. In low and middle-income countries, that’s a major disincentive to stopping their overuse.
Even vegetables can be affected
For all of you who enjoy a plant-based diet, I’m afraid you are not exempt from similar problems.
Antibiotic manufacturers have been polluting the environment for decades, so too has our improper disposal of antibiotics, and when we and animals excrete antibiotics or their breakdown products into sewage it gets into soil and waterways.
Environmental bacteria are exposed to greater amounts of antibiotics, and the cycle of exposure-advantage-exposure Continue readingThe environment is becoming more resistant to antibiotics. They can then be introduced to the food chain by way of animals or directly to humans.
Many reports have been made about fruit and veg carrying antibiotic resistant bacteria at point of sale, including tomatoes, spinach, lettuce, cucumber, green beans, and sprouts to mention a few, and from all parts of the world, including here in South Africa.
It should be clear by now, that the pandemic of antibiotic resistant bacterial infections is a multifaceted problem, which provides one of the best examples of what we call a ‘One Health’ issue – one that affects human, animal, and environmental health.
The only way to reduce the impact this pandemic has to be to intervene to stop the misuse and overuse antibiotics in all three areas. This article will discuss what you can do as an individual to break the cycle and protect your health and that of the public.
Marc Mendelson is Professor of Infectious Diseases and Head of The Division of Infectious Diseases and HIV Medicine, University of Cape Town.
GroundUp has the original version. Here.