Antibiotics: use or abuse?

Antibiotic resistance is increasing worldwide to dangerous levels. New resistance mechanisms are emerging and spreading across the globe every day, jeopardizing our ability to treat common infectious diseases. A growing number of infections, such as pneumonia, tuberculosis, sepsis, gonorrhoea and foodborne illnesses, are becoming more difficult – and sometimes impossible – to treat as antibiotics become less effective.

Where antibiotics are available over the counter for human or veterinary use, the emergence and spread of drug resistance is worsening. In countries lacking standardised treatment guidelines, healthcare and veterinary staff tend to overprescribe and the general public overuse antibiotics.

Without urgent action, the world is headed towards a post-antibiotic era in which many common infections and minor injuries will once again become life-threatening.

When infections can no longer be treated with first-line antibiotics, more expensive drugs must be used.

The longer duration of illness and treatment, often in a hospital setting, increases healthcare costs and the economic burden on families and society.

Antibiotic resistance is putting the achievements of modern medicine at risk. Without effective antibiotics to prevent and treat infections, organ transplants, chemotherapy and surgical procedures will become more dangerous.

Although we know that bacterial resistance is a natural process and cannot be stopped, we can contain it. In Spain we have the National Plan against Antibiotic Resistance (PRAN), with two strategies: reducing the consumption of antibiotics and decreasing the need to use them in human and veterinary medicine. How? With these six guidelines that we tell you about below.

1. Do not self-medicate

You should never save leftover antibiotics. If a family member who had a throat infection was prescribed a certain drug and there was a lot left over, you should never save it and use it for possible infections that may occur in the future. It is almost certain that it will not be the right one for that person. It should not be forgotten that of the four million consultations a year in Spain for sore throat, 70% are due to viral causes, which usually heal on their own.

2. Prescribe the right medication

There are broad-spectrum antibiotics that will certainly kill a tonsil infection, but it may not be necessary to take them to kill the bacteria causing the infection. Using a broad-spectrum antibiotic to kill the bacteria causing tonsils only makes the bacteria resistant.

4. Complete the cycle dictated by the protocol

Often, someone with tonsils takes an antibiotic for two days, but when they feel better, they stop taking it. There hasn't been enough time to kill the bacteria, so they stay there, multiplying and generating more resistance. There has been a lot of talk about the ideal duration of antibiotic treatment, whether they should be shorter or not - some studies have shown that shorter cycles can be just as effective as longer ones in some infections - but the final say on the duration of the antibiotic rests with the doctor, who always has up-to-date clinical data to provide the patient with the appropriate information.

5. Avoid use in healthy animals

Humans are not the only ones who take antibiotics. Society must monitor and not consume foods that use antibiotics to stimulate growth or prevent disease in healthy animals. That is why the European Union has banned the use of antibiotics to promote animal growth since 2006. According to European legislation, only veterinarians can prescribe antibiotics to be administered to animals and establish the correct dosage and duration of treatment.

6. Hygiene and vaccination, key measures

Washing your hands with soap and water frequently and using alcohol-based hand sanitizer protects you from harmful bacteria. Healthy habits such as eating a healthy diet, handling food properly, disinfecting surfaces, and exercising also help reduce the risk of developing infections. On the other hand, although we know that antibiotics do not treat viruses, it is possible that a viral infection, such as the flu, may end up being complicated by secondary bacterial infections that do require antibiotics, such as pneumonia. Getting vaccinated against the flu or chickenpox, which is also a viral disease that can lead to bacterial skin infections or pneumonia, will help reduce the use of these drugs.

The fight against antibiotic resistance is a high priority for WHO . In May 2015, the World Health Assembly adopted a global action plan on antimicrobial resistance, including antibiotic resistance. Its aim is to ensure that infectious diseases can continue to be prevented and treated with effective and safe drugs.

At the United Nations General Assembly in September 2016, Heads of State committed to addressing in a comprehensive and coordinated manner the root causes of AMR across different sectors, including human health, animal health and agriculture . WHO is supporting Member States in developing national action plans on AMR based on the global action plan.