Antibiotic abuse… a ticking public health time bomb

Every day in Nigeria, millions of people are taking various antibiotics, popularly known as “capsule” for a variety of illnesses ranging from fever to headache, diarrhea, body pain, common cold, malaria, birth control, constipation to name a few. In fact there is a “capsule” for every disease one can imagine- red and black ones, yellow and red ones, plain white ones….
In the vast majority of cases, these antibiotics are bought over the counter without prescriptions at chemist shops or even sold by medicine hawkers in the market, who display their wares in open trays, with no obvious labels and the doses of these antibiotics are left to the imagination of the sellers and users. There are even cases where patients feel the doctors who insist on clinical and laboratory evidence before prescribing antibiotics (obviously doing the right thing) are perceived by their patients as “not knowing what they are doing “ or being “difficult”.

Another problem with antibiotic use is when patients don’t finish their prescribed dosages, and stop taking their drugs earlier than prescribed because the symptoms have improved. Most of the time, the bacteria are not quite dead, and may cause lingering subclinical damage, only to cause complications and more severe infections in future.

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Sharing of prescribed antibiotics is another major problem we face. Why would you give someone drugs that where prescribed for a particular problem to someone else without knowing what exactly is the cause of their own problem? No, all coughs are not caused by the same organism (the cause may even be viral)!!

What are antibiotics?
Antibiotics are drugs formulated to treat BACTERIAL INFECTIONS. They are completely useless against viral infections like the common cold and fungal infections like some skin problems. Antibiotics designed to treat a specific class of bacteria will not be effective against other classes of bacteria.

When should antibiotics be prescribed?
1. When there is an evidence of bacterial infection: fever, features suggestive of infection in the lab tests.
2. They can be prescribed if there are no lab tests by experienced doctors with the knowledge of infection patterns in the community.

What are the dangers of using antibiotics when not needed?
1. Exposure to side effects. such as: skin rash, diarrhea, vomiting, nausea, deafness, kidney damage, brain problems, swelling of the throat, making it difficult to breathe (which may be life threatening).

2. Antibiotic resistance: Antibiotic resistance is rising to dangerously high levels in all parts of the world. A growing list of infections like pneumonia, tuberculosis, blood poisoning, gonorrhea, and foodborne diseases – are becoming harder, and sometimes impossible, to treat as antibiotics become less effective. Imagine a world where we can no longer treat pneumonia and other infectious diseases… The death toll will be huge!!!! Currently, at least 700,000 people die each year due to drug-resistant diseases, including 230,000 people who die from multidrug-resistant tuberculosis. More and more common diseases, including respiratory tract infections, sexually transmitted infections and urinary tract infections, are untreatable, due to antibiotic resistance. The UN Ad hoc Interagency Coordinating Group on Antimicrobial Resistance warns that if no action is taken, drug-resistant diseases could cause 10 million deaths each year by 2050.

What can we do to prevent this catastrophe?
1. As individuals:
Only use antibiotics when prescribed by a certified health professional.
Never demand antibiotics if your health worker says you don’t need them.
Always follow your health worker’s advice when using antibiotics.
Never share or use leftover antibiotics.
2. Health professionals:
Only prescribe antibiotics when they are needed, according to current guidelines.
Talk to patients about how to take antibiotics correctly and the dangers of misuse.
Talk to patients about preventing infections (for example, vaccination, hand washing, safer sex, and covering nose and mouth when sneezing).
Public health and safety is a collective responsibility. The next time you are using antibiotics, ask yourself: “Do I really need this?” and please always remember to finish the dose prescribed by the doctor, even if symptoms clear up after a few days.

Dr Monisola Adanijo FMCP a Cardiologist and the Medical Director at Naveen Healthcare.
With experience spanning over 20 years, she built her pathway in medicine and cardiology working in reputable medical centres such as Mecure Healthcare Limited, Barnes Hospital, Lagos University Teaching Hospital, University College Hospital, Ibadan, Chevron Hospital, Lagos to mention but a few.
Her passion for preventive cardiology led her to convene the Naveen Healthcare 10,000 Hearts Project, in order to help individuals detect, protect and correct cardiovascular diseases.

Skilled in cardiovascular diagnostic procedures and treatment, a fellow of the National Postgraduate Medical College of Nigeria, a member of Nigerian Cardiac Society, American College of Physicians, Hypertension society of Nigeria and an international associate of the American College of Cardiology. She also has a Diploma in Leadership and Management from the University of Washington, USA, She launched the first TeleElectrocardiogram project in Nigeria and West Africa and does her part in contributing to good health and wellbeing, a Sustainable Development Goal (SDG3) of the United Nations.
Linkedin: Monisola Adanijo

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