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Antibiotics: Getting too much of a good thing

Microorganisms are becoming more resistant to antimicrobial drugs and thus patients with certain diseases are being left in the lurch.

Antibiotics: Getting too much of a good thing

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Antibiotics are often regarded as a “magic bullet” to kill bacteria which are the cause of most infectious diseases. The trouble is these microorganisms are becoming more resistant to antimicrobial drugs and thus patients with certain diseases are being left in the lurch. It has reached the point that Singapore has formed an inter-ministerial committee to provide a whole-of-government effort to fight antimicrobial resistance. Just how did this serious state of affairs arise?

The short answer is public misconception and weak professional standards have contributed to the overuse of these useful drugs which unfortunately is making them less useful. Educating people about antibiotics and working with professionals and industry players are part of the “National Strategic Action Plan” which was launched recently to tackle a problem with potentially devastating consequences: if antimicrobial resistance mounts, even simple infections could kill.

Ordinary people might fail to distinguish between bacteria and viruses (which are often the cause of a sore throat and the common cold). Antibiotics are ineffective against viruses but patients might still demand these drugs. It is bad enough that many doctors tend to over-prescribe antibiotics, but patients make it worse by skipping doses, saving antibiotics for future bouts of illness, and consuming such medicine meant for someone else.

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Completing the full course of the drug is routinely emphasised by doctors, but new research suggests that an extended treatment course is appropriate only for certain cases. For simple infections, “a better message would be that antibiotics are a precious resource that should not be used for longer than is necessary,” said Oxford University professor Lucy Yardley.

The president of the British Society for Immunology also agreed that shortening antibiotics courses may help tackle the resistance problem. The Singapore work group should, therefore, examine prescribing practices and clarify guidelines which will be most beneficial to public health in the long run.

The message to people, which should also include children, should be simplified so they can better appreciate the nature of microbes. Few realise that bacteria are born to adapt to the external environment. They can change their surrounding layers, including genetic information, in order to resist drugs, and can even pass on these characteristics to future generations of bacteria.

In the classic science fiction novel, War Of The Worlds, by HG Wells, invading aliens were finally defeated by simple microorganisms on earth that humans had become immune to. The irony is that instead of preserving such immunity, people are creating super bugs resistant to all known drugs, by overusing and abusing antibiotics.

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