By Henrylito D. Tacio
Filipinos use antibiotics inappropriately, observed Dr. Emmanuel Edwin R. Dy, then senior
research specialist at the Philippine-Australia Cooperation Project on National Drug Policy.
This was based on the results of his 1995 study, which he presented in a symposium
convened by the Philippine Council for Health Research and Development.
“This research was brought about by the desire of the government to address the problem
of antimicrobial resistance in the country,” Dr. Dy pointed out during the symposium. “The
government wanted somebody to come up with raw data, with hard evidence that there is
resistance brought about by inappropriate use of antibiotics.”
Dr. Dy acknowledged the problem of inappropriate use of antibiotics, which leads to
improper use of the drugs in the Philippines, rather complicated. “There is no simple
solution,” he said, adding that most Filipinos use antibiotics inappropriately because of
misconception, financial constraints, prescription recycling, and widespread self-
medication.
The Philippines, however, is not alone in this dilemma. “In many countries, antibiotics are
available without a doctor’s prescription, which lets patients diagnose and dose
themselves, often inappropriately,” Time journalist Michael D. Lemonick wrote. “And high-
tech farmers have learned that mixing low doses of antibiotics into cattle feed makes the
animals grow larger. Bacteria in the cattle become resistant to the drugs, and when people
drink milk or eat meat, this immunity may be transferred to human bacteria.”
But even when doctors dispense antibiotics properly, there is no guarantee they’ll be used
that way. Several studies have shown that a third of all patients fail to use the drugs as
prescribed.
How resistance happens is being explained by Sally Davies in her book, The Drugs Don’t
Work. She describes how bacteria become resistant to drugs when a person doesn’t take
antibiotics for long enough.
“If the drugs are not given enough opportunity to fully kill the bacteria it may survive while
also learning how to resist future treatment with the same drug,” Davies wrote. “This is
why it is important that antibiotics are only taken exactly as prescribed by a trained
medical professional.”
In his special Time report, Lemonick wrote: “Patients frequently stop taking antibiotics
when their symptoms go away but before an infection is entirely cleared up. That
suppresses susceptible microbes but allows partially resistant ones to flourish.”
The inappropriate use of antibiotics is the primary cause of the emergence of what health
experts call superbugs. These are antibiotic-resistant bacteria that pose a deadly threat to
humanity; in fact, they are now evolving to become a global threat.
“If we keep using antibiotics improperly, the day may come when our antibiotics no longer
work against bacterial infections-we will have an infectious disease apocalypse that will
endanger the human race,” said Dr. Rontgene M. Solante, an internist and infectious
diseases specialist.
That day may already be happening now. The Geneva-based World Health Organization
(WHO) said resistant bacterial infections are now associated with nearly 4.95 million
deaths per year.
Another disturbing fact is a new report released by the WHO which showed high levels of
resistance in bacteria, causing life-threatening bloodstream infections, as well as increasing
resistance to treatment in several bacteria causing common infections.
“The report shows high levels (above 50%) of resistance were reported in bacteria
frequently causing bloodstream infections in hospitals, such as Klebsiella
pneumoniae and Acinetobacter spp.,” the WHO said in a press release. “These life-
threatening infections require treatment with last-resort antibiotics, such as carbapenems.
However, 7% of bloodstream infections caused by Klebsiella pneumoniae were reported as
resistant to carbapenems, increasing the risk of death due to unmanageable infections.”
Common bacterial infections are becoming increasingly resistant to treatments. Over 60%
of Neisseria gonorrhea isolates, a common sexually transmitted disease, have shown
resistance to one of the most used oral antibacterial, ciprofloxacin, the WHO said.
Over 20% of Escherichia coli isolates, the most common pathogen in urinary tract
infections, were resistant to both first-line drugs (ampicillin and co-trimoxazole) and
second-line treatments (fluoroquinolones).
Every disease-causing bacterium now has versions that resist at least one of medicine’s
100-plus antibiotics. In fact, there is now such a thing as antimicrobial resistance (AMR), a
phenomenon where infectious microorganisms previously susceptible to a certain drug
become eventually resistant to such treatment.
“Antimicrobial resistance undermines modern medicine and puts millions of lives at risk,”
deplored Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.
Resistance, however, is inevitable. “Resistance is a natural phenomenon that has always
occurred following exposure to antibiotics,” Dr. Nicholas Brown, a medical microbiologist,
told Reader’s Digest. “The more we use antibiotics, the more resistance will emerge and the
less effective they become.”
Unfortunately, new antibiotics aren’t being developed fast enough to keep pace with the
resistance. “A lot of big pharmaceutical companies have withdrawn from antibiotic
development, because it is high risk,” explained Dr. Brown, head of Antibiotic Action, a
global initiative to raise awareness of drug resistance. – ###
