Antibiotics misuse, overuse a growing concern
The growing problem of the misuse of antibiotics remains a serious challenge to the public health, resulting in an alarming increase in the burden of becoming colonized or infected with a resistant organism.
Speaking on the occasion, Dr Pema Chuki of JDWNRH reported that between 20 to 50 percent of antibiotic prescriptions are either unnecessary or inappropriate.
The misuse of antibiotics, she reported was given when they are not needed, the wrong antibiotic is chosen to treat an infection, continued when they are no longer necessary, given at the wrong dose and broad spectrum agents are used to treat very susceptible bacteria.
Overuse of antibiotics may result in the increased emergence and spread of multidrug-resistant bacteria. Dr Pema Chuki said, “Increasing use of antibiotics in healthcare settings increases the prevalence of resistant bacteria in hospitals.”
Dr Pema Chuki said, “The rising number of Antibiotics misuse and overuse are resistant to antimicrobials is of great concern.”
She said a leadership commitment is required to support for efforts to improve and monitor antibiotic prescribing, assurance that the involved staff has time, and authority and accountability in the place.
Dr Pema Chuki said the guidelines, policies, and protocols alone would probably not change the practice. However, she recommended that active interventions such as prospective audit, formulary restriction and preauthorization, Antibiotic ‘Time Out', IV to oral switch, de-escalation therapy and dose optimization are most effective.
Chhimi Lhamo with nursing department also recommended that dedicated full time infection control nurse is required in the hospital and cleaning resource and disinfectants need to be avaliable all the time. “Hand hygiene compliance need to be improved among all the health workers, and required regular monitoring and supervision of IC practices,” she said, adding that isolation ward is also required in the hospital.
Thupten Tshering, Head of Pharmacy Department, said it is time for a national data on antibiotic use. He said, “Information on antibiotic consumption is useful in influencing the antibiotic prescribing behaviour.”
Tandin Dorji, Chief program officer of Health Care and Diagnostic Division, Department of Medical services, said people
are not educated on the impact of antibiotics if taken without the advice of health professionals as health care being free, and in particular, medicines being free of charge. He said, “This not only puts them in danger but also exacerbates the cost involved in treating the patients.”
The press release from health ministry states that in many places, antibiotics are overused and misused in people and animals, and often given without professional oversight. “Examples of misuse include when they are taken by people with viral infections like colds and flu, and when they are given as growth promoters in animals or used to prevent diseases in healthy animals.”
Combating antimicrobial resistance should not be difficult in Bhutan as the use of antibiotics is mainly restricted to government hospitals and veterinary centers.
According to the health ministry, the sale of antibiotics from the private pharmacies constitutes only a small fraction of antibiotics used in the country whose sale is well regulated and the use of antibiotics in agriculture sector has been kept to minimum.
However, the country cannot be complacent and effective monitoring and surveillance of the antibiotic use in both human and animal health has to be established and sustained. The ministry says, “The core focus at this time however, should be on ensuring the rational use of antibiotics in the hospitals and veterinary centers and enhancing public education and at the same time.”
The health ministry seeks action against antibiotics to protect the generation from infections. “We have to act now and we have to act together. We owe it to ourselves, and we owe it even more to our children.”
The World Health Organization (WHO) also warned that antibiotics consumption is dangerously high in some countries while a shortage in others is spurring risky misuse, driving the emergence of deadly superbug infections.
The WHO report, based on 2015 data from 65 countries and regions, showed a significant difference in consumption rates. It states, “The large difference in antibiotic use worldwide indicates that some countries are probably overusing antibiotics while other countries may not have sufficient access to these lives-saving medicines.”
To stop the unnecessary use of antimicrobials in healthcare and in agriculture, and through better diagnosis and prevention of infection in healthcare settings and communities, the Ministry of Health in collaboration with the WHO observed the World Antibiotics Awareness Week globally from 12 to 18 November in Thimphu and other hospitals in nine Dzongkhags.
The themed “Our Time with Antibiotics is Running Out. Change Can't Wait” is aimed at spearheading the advocacy and awareness activities to the public on the increasing threat of AMR globally.
In many places, antibiotics are overused and misused in people and animals, and often given without professional oversight