Under the most discussed topic in pharmacy, “Rational use of drugs”, antibiotics are almost always highlighted as the class of drugs which are used inappropriately every day by patients worldwide. This week’s article seeks to explain the rational use of antibiotics and further discuss the repercussion of its improper use both at the micro and macro levels.
As the name suggests antibiotics are prescribed by a doctor whenever there is bacteria present either in the tissue or organ. There are various types of organisms or even the same type of organism which can infect the different organs. For example there could be streptococcal bacteria infecting the skin, the largest organ of the body presented as fluid filled reddish boils or streptococcal bacteria infecting the pharynx or throat presented with a sore throat, elevated body temperature and sometimes painful swallowing. There are numerous types of known bacteria and sub-groups which can infect any organ from the respiratory tract to the central nervous system and also newly discovered strains as research continues to unfold medical mysteries.
Antibiotics are classified in groups which have their own spectrum of coverage for different organism. The main criterion used for the selection of a suitable antibiotic is the activity against the causative organisms in that infection. The sure way of knowing which bacteria to target is by doing a culture and sensitivity test but this may take about a week before the organism is identified. So in the interest of time especially to prevent a severe condition from worsening a doctor may select an antibiotic without a culture test using his or her experience on the most prevalent organism in that particular infection.
The other factor the doctor would want to consider is the patient profile where the following questions should be asked to ascertain this information. Do you have any known allergies? If the patient is a female are you pregnant, breast feeding or taking oral contraceptives? Are you suffering from any other illnesses or taking any other medication? The doctor would want to establish if there is any compromised kidney or liver function or if the person’s immune system is compromised. Another important piece of information to obtain when taking the medical history is whether the person was already on antibiotic treatment and the regimen which includes the dosage and duration.
Sometimes a combination of antibiotics is prescribed so that a broader range of organisms can be targeted thus potentiating the effect of one drug. Combination therapy is one known way to limit drug resistance to antibiotics for certain conditions. Drug resistance can also be limited by avoiding indiscriminate use thus ensuring that the antibiotic is used for the right indication and that the dosage and duration of treatment are appropriate. The use of new antibiotics should also be restricted by a protocol and should stipulate concurrence between the culture and sensitivity tests and the supervising doctor. It is imperative that the clinician monitors and highlights any drug resistance both in the hospital setting and the community.
Consequences of the irrational use of antibiotics can be catastrophic on both the individual level and the national level. If the inappropriate antibiotic is selected or the right antibiotic is used inappropriately then the invading causative organism will continue to multiply and a new strain of resistant bacteria can emerge. If the patient is not able to obtain a higher level antibiotic because of cost or availability then the patient can succumb to the infection after a period of prolonged suffering. In the case of a contagious illness especially in a hospital setting, the newly resistant bacteria can be transmitted to other persons and an epidemic can start which can create a national disaster.
With regards to HIV/AIDS, which is a virus caused illness and NOT caused by bacteria the same argument for drug resistance holds. This disease condition if not monitored closely can have a catastrophic impact on the national economy if medications are either not prescribed correctly or used as directed by the trained doctor. The reason being new strains of resistant virus can be formed which can be very expensive to sustain treatment especially if risky behaviour is continued by productive age groups of the country.
So now that you understand why you must get a prescription for antibiotics we expect a more compliant approach to the use of such meds. It is in the best interest of the patient’s health that both the prescriber and patient observe rational drug use of antibiotics and prevent the drug resistance challenge that lingers.
For further information please call the pharmacist at Medicine Express located at 223 Camp Street, between Lamaha and New Market Streets.
If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.