Antimicrobial resistance: corrections necessary to tackling antibiotics misuse

Antimicrobial resistance (AMR) has been rising for years, with Nigeria’s ability being limited to combating it, there are corrections necessary to tackle the misuse of antibiotics, including when it is appropriate to take antibiotics.

However, Nigeria is among the low- and middle-income countries, where people can purchase antibiotics over the counter without a prescription, or where substandard antibiotics are sold in disadvantaged regulated markets, adding to fuelling resistance.

The burden of AMR remains significantly high in Nigeria. Over-use of antibiotics includes: self-medication, sharing antibiotics with others, and misuse of these medicines predisposes as one of the reasons antibiotics are becoming less effective.

Bad use of antibiotics was common with 42 percent of adults and 46.7 –71.1 percent of five years children being given antibiotics without a prescription, and 68.3 percent of adults used antibiotics following the prescription, according to the National Action Plan for Antimicrobial Resistance, 2017-2022.

Antibiotic resistance (AMR) has been recognised as a global health threat. The World Health Organisation (WHO) has declared it as one of the top ten global public health threats confronting people and tackling the global problem requires that people around the world understand what the problem is and what is causing it.

In 2019, the United Nations Ad hoc Interagency Coordination Group on AMR warned that drug-resistant diseases could cause 10 million deaths each year by 2050, damage the economy and force up to 24 million people into extreme poverty by 2030, if no action is taken.

Antimicrobial resistance occurs when medicines no longer work as they should against infections caused by pathogens which include bacteria (antibiotics), viruses (antivirals), fungi (antifungals), and parasites (antiparasitics) resisting the effects of the medicines used to treat them, leading to drug-resistant infections.

The WHO has identified antibiotic resistance in Mycobacterium tuberculosis strains that threaten progress in containing the global tuberculosis epidemic. Also, drug resistance in viruses leads to Antiviral drug resistance. The viral replication and prolonged drug exposure have led to the selection of resistant strains. Resistance has developed to most antivirals including antiretroviral (ARV) drugs.

AMR, particularly in Gram-negative bacteria, is widely recognised as one of the biggest threats to global public health today; causing 700,000 deaths annually.

For World Antimicrobial Awareness Week (WAAW), recognised Nov. 18 -24 each year, this year’s theme is ‘preventing antimicrobial resistance together.’ In line with this theme, WHO emphasises the need to adopt the One Health approach, bringing together multiple sectors and stakeholders engaged in human, animal, and plant health, and the environment to work together in designing and implementing programmes, policies, legislation, and research to attain better public health outcomes.

Despite continued awareness, many Nigerians still do not have the understanding and the wider implications of AMR, recognising that this does not only pose threat to human health, but to animal health and environmental health.

However, there have been reviews by medical experts and stakeholder addressing concerns on ways Nigerians can get involved by taking part in corrections of antibiotic misuse.

The highlights of these reviews demand that Nigerians should do away with old or unused antibiotics lying around in the house.

Antibiotics would better prescribe by licensed physicians, and pharmacists, who understand the best practice and know the effects of misuse and are not accessible over the counter at pharmacies if not licensed.

Also, unnecessary use of antibiotics can be improved by simple hand hygiene and a change in attitude with increasing public education and awareness of individuals respond to the impacts of AMR and when it is appropriate to take antibiotics. Doctors, pharmacists, and patients understand the risks of overuse, underuse, and misuse of antibiotics.

The market potential for new antibiotics is limited, due to the steep costs of antimicrobial development, high risk of failure, long lead times, and growing awareness of the need to limit their use.

These reviews nevertheless peg surveillance as a key activity to determine AMR burden, impacts, and trends and monitor the effects of interventions. To accomplish this, Pfizer sponsors one of the largest AMR surveillance programs in the world – The Antimicrobial Testing Leadership and Surveillance (ATLAS) database, which monitors changes in populations of microbes to help understand evolving patterns of resistance to anti-infectives.

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“Despite the challenging antimicrobial R&D landscape Pfizer continues to evaluate opportunities and partnerships to expand our pipeline. Pfizer is one of the few large research-based pharmaceutical companies still active in research and development (R&D) for anti-infectives and works with partners to close critical prevention and treatment gaps in infectious diseases around the globe,” says Kodjo Soroh, medical director, East, and Anglo West Africa, Pfizer.

Soroh added that governments, industries, and the public health communities must work together to take action and support measures to enable continued innovation in the development of new antibiotics and vaccines and help curb the spread of AMR.

However, Pfizer is actively engaged and committed to a multi-faceted and evidence-based approach to stewardship, to ensure responsible use of anti-infectives across local healthcare settings.

These efforts include health system strengthening, surveillance, and infection prevention, including vaccination, policy advocacy, innovative tools, diagnostics, education, research, health equity, and patient engagement.

Pfizer has one of the world’s largest AMR surveillance website platforms – the ATLAS database, that provides physicians and the global health community with open access to data on bacterial sensitivity to various antibiotics and emerging resistance patterns in 83 countries, including those with less specialised health networks.

Antibiotics is a life- saving medicines, however, require better regulatory reforms across the country. To tackle antibiotic misuse, people have to be dedicated and know the consequences of antibiotic misuse, and once prescribed, it must be used the way it has been prescribed, says Doyin Odubanjo, public health expert based in Lagos “curbing antimicrobial resistance this can be properly addressed through coordinated partnerships between the public and private sectors across different value chains.”