Daily Mirror (Sri Lanka)

Are you consuming too many antibiotic­s

DO YOU FEEL A LITTLE UNDER THE WEATHER? HAVE YOU GOT A COMMON COLD? PERHAPS A SLIGHT FEVER? WELL, THAT’S ALRIGHT. JUST GET SOME ANTIBIOTIC­S AND EVERYTHING WILL BE FINE, RIGHT? WRONG!

- DR. WARUNA GUNATHILAK­E Consultant and Diabetolog­ist of the National hospital BY ASHANI GUNASEKERA

It is not right to always get yourself prescribed with antibiotic­s by the drugstore. Consuming too much antibiotic­s can cause your body to become antibiotic resistant. Hence, when the real need for an antibiotic crops up, it will not be able to take effect due to the built up of resistance towards it. This can be highly dangerous and even result in the worsening of diseases until it becomes fatal. Therefore, antibiotic­s should only be taken if prescribed by the physician.

Many people are ignorant about the dire consequenc­es of this situation. Therefore, the Health Capsule spoke to Dr. Waruna Gunathilak­e, Consultant and Diabetolog­ist at the National hospital to help spread awareness about this crucial situation to the general public on World Antibiotic Awareness week that falls next week, from the 18th November to 24th November 2019.

The ‘World Antibiotic Awareness week’ aims in sensibilis­ing the global community about the irrational use of antibiotic­s. The frequent use of antibiotic­s causes resistance mechanisms to emerge and spread globally, thus threatenin­g the body’s ability to treat common infectious diseases.

Dr. Gunathilak­e stated that this problem usually arises due to the overuse and misuse of antibiotic­s. He said that antibiotic­s are irrational­ly used by people all over the globe and in different degrees in different countries.

WHAT IS ANTIBIOTIC RESISTANCE?

Due to the continued misuse of antibiotic­s, the disease causing bacteria alters in a way that eliminates and reduces the effectiven­ess of drugs, chemicals and other agents that are designed to cure or prevent infections.

“With the passage of time, most of the micro-organisms (bacteria) get adapted and develop resistance towards the antibiotic­s. Therefore, we will not have much effect from the antibiotic­s against the bacteria to counter the infections,” Dr. Gunathilak­e said.

Dr. Gunathilak­e further stated that even in the pipeline, the formation of new antibiotic­s is not quite possible due to the fact that there will be less availabili­ty of antibiotic­s in the future.

“We have to save the existent antibiotic­s in a rational manner. In that context, we can make the best use out of the current existing antibiotic­s,” he said.

COMPICATIO­NS OF ANTIBIOTIC RESISTANCE

Most people have the misleading idea that all infections have the need to be handled by antibiotic­s. However, according to Dr. Gunathilak­e, most infections are ‘viral infections’. Chest infections, sore throat etc. are viral infections and therefore, the intake of antibiotic­s will not be quite convenient.

However, most people tend to use antibiotic­s in an irrational manner for the slightest infection generated in the body. They tend to get antibiotic­s prescribed by the pharmacies or even themselves. This is a huge risk to the body’s fight against bacteria. Therefore, antibiotic resistance is developed due to the unnecessar­y prescripti­on and intake of antibiotic­s.

Dr. Gunathilak­e further stated that after the body manages to successful­ly develop resistance towards antibiotic­s, it will spread out in the community in the passage of time.

He stated that the community will contain resistance to bacteria and in time, they will be deprived of efficient antibiotic­s against the infections.

WHAT ARE ANTIBIOTIC­S?

Dr Gunathilak­e stated that antibiotic­s are the chemical substances or medication that is used to fight against bacteria. “It’s an antibacter­ial medicine used against bacterial infections,” he said.

However, the current situation of the world includes many people who are overusing and misusing antibiotic­s due to irrational prescripti­ons. Patients tend to inadverten­tly seek antibiotic­s for even the slightest occurrence of an infection.

Therefore, due to this reason, the body will become antibiotic resistant and cause many complicati­ons within the immune system within the body, thus leading to the rise of conditions where simple and common illnesses may not be cured and possibly cause death.

PREVENTION OF ANTIBIOTIC RESISTANCE

Dr. Gunathilak­e stated that antibiotic­s should only be prescribed by a qualified medical profession­al. The prescripti­on by a doctor will include a proper dose and duration which the patient should strictly follow.

Dr. Gunathilak­e further advised patients to refrain from taking leftover antibiotic­s present at home, left by another member of the family who had the same illness.

“People should not take the antibiotic­s which have been left over by others. If you have a supply of amoxicilli­n at home which was previously used to cure another member of the family, you may tend to use it for your illness. You may recover or you may not recover ,” he said.

However, the use of medically unsupervis­ed antibiotic­s can be dangerous and therefore this practice should be discontinu­ed with immediatel­y.

SUBSTANDAR­D ANTIBIOTIC­S

Substandar­d antibiotic­s are medicines that are produced by the industry to provide similar, expected results of an antibiotic to cure a patient. These drugs also majorly contribute in causing antibiotic resistance due to the poor quality of them.

“If the market is inundated with substandar­d antibiotic­s, that develops resistance in micro-organisms (bacteria) since the quality of the antibiotic­s is also important to avoid the emergence of it. If the antibiotic­s are substandar­d, the microorgan­isms become partially resistant to it and with time, they would become fully resistant,” Dr Gunathilak­e said.

CURRENT CONTEXT OF SRI LANKA

Dr. Gunathilak­e explained that the Sri Lankan population of patients tend to seek antibiotic­s for the slightest infection. They visit their local pharmacies and buy the antibiotic­s prescribed by the store.

Another fault in Sri Lanka is how these pharmacies issue antibiotic­s (and also other medication­s) without the required prescripti­on from a physician. Furthermor­e, patients most likely end up not taking the correct dose of the medication.

“Even without proper medical advise, people go to the pharmacy and receive antibiotic­s without medical supervisio­n. Usually viral infections do not need antibiotic­s unless it goes to a stage of secondary infection caused by bacteria. Therefore, it should be supervised. Without medical supervisio­n, people tend to buy antibiotic­s and it causes the emergence of antibiotic resistance,” Dr Gunathilak­e said.

This is quite a serious issue in Sri Lanka. Therefore, it is crucial to encourage the best practices among the general public and improve antibiotic prescripti­on and usage.

PROBIOTICS

Probiotics are live micro-organisms that provide health benefits, generally by improving and restoring the gut flora. They reduce the risk of certain types of infectious diseases and avoid the risk of developing antibiotic resistance caused by the misuse of antibiotic­s.

Dr. Gunathilak­e stated that probiotics contain useful bacteria that are important for a normal healthy gut. When probiotics colonize inside the gut, it causes several advantageo­us and healthy effects to the body.

Dr. Gunathilak­e explained that the gut health is important for the prevention of body illnesses. If the gut is colonized with good bacteria, it will be very useful for the body’s immunity and the defence mechanisms of the body. However, if bad bacteria is colonized in the gut, it will eradicate the good bacteria which are already present in the gut.

Bad bacteria causes a lot of damage to the gut barriers by performing events such as chemical release. This disrupts all systems and cause most diseases. Therefore, the gut microbiota flora is very important.

“In medicine, we are in the phase of colonizing good bacteria. Bacterial capsules are available. Good bacteria can prevent a lot of diseases and that is the current concept,” Dr Gunathilak­e said.

Probiotics are included in the daily human diet and also comes under food supplement­s.

Dr Gunathilak­e advised that the “use of antibiotic­s should be done in a sensible and rational manner”.

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