PROBLEMS ASSOCIATED WITH THE USE OF ANTIBIOTICS
Introduction
Antibiotics refer to drugs that are used to prevent or treat bacterial infections. They act by killing bacteria or preventing them from spreading or reproducing (Nathan and Cars, 2014). Antibiotics are not routinely prescribed because the immune system can clear bacterial infections. Huh and Kwon (2011) explain that antibiotics are prescribed when a bacterial infection overwhelms the immune system. They are also used to prevent bacterial infections that would spread to others if untreated (Sommer and Dantas, 2011). Bergen et al. (2012) illustrate that doctors also prescribe antibiotics when the infection is taking a long to clear. Furthermore, antibiotics are used for the purpose of preventing complications from simple bacterial infections (Dryden, Johnson, Ashiru-Oredope, and Sharland, 2011). Therefore, antibiotics are lifesavers. However, antibiotics are associated with serious problems that must be addressed for the full realization of their benefits. This paper presents a critical discussion of the main problems associated with antibiotics in healthcare and farming and industry. Recommendations for evidence-based strategies for addressing specific problems with antibiotics are also presented in the paper.
Healthcare
Andersson and Hughes (2014) reveal that antibiotics are approved and released to the market after a thorough screening for adverse effects. Therefore, antibiotics are generally tolerable and safe. However, there is a wide range of adverse effects associated with the use of antibiotics. Notably, different antibiotics exhibit varying levels of severity of adverse effects (Bergen et al., 2012). Andersson and Hughes (2014) explain that the adverse effects of antibiotics are influenced by patient factors, their toxicological and pharmacological characteristics, and the kind of bacteria they target. Huh and Kwon (2011) indicate that antibiotics may cause serious allergic reactions in some patients. Nausea and diarrhea are other common side effects of antibiotics. Patients are often advised to contact their physicians in case they experience serious side effects after taking antibiotics (Andersson and Hughes, 2014). In addition, individuals taking antibiotics as advised against the use of alcohol because it amplifies the adverse effects of most antibiotics (Nathan and Cars, 2014).
Resistance to bacteria is another common and serious problem associated with antibiotics. Resistance refers to the ability of bacteria to survive the antimicrobial effects of antibiotics (Dryden, Johnson, Ashiru-Oredope and Sharland, 2011). Andersson and Hughes (2014) demonstrate that resistance to bacteria makes antipatriotic ineffective in combating certain bacterial infections. Resistant bacteria continue to multiply in the body of affected individuals, which worsens the infection or causes serious complications. According to Freire-Moran et al. (2011), resistance occurs due to the evolutionary mechanisms of bacteria that enhance them genetically and physiologically to the extent that they can survive antibiotics or other chemicals. Huh and Kwon (2011) state that antibiotic resistance is reported as one of the pressing problems in public health across the world. This is because the resistance of bacteria makes infections that were previously treatable become overly dangerous. Antibiotic resistance is also a concern because it prolongs the suffering of children and adults who have infections and it causes many deaths (Andersson and Hughes, 2014). Bergen et al. (2012) explain that when antibiotic-resistant bacteria spread in families and communities, they pose a threat to the whole population. Treating infections caused by antibiotic-resistant bacteria are also expensive and therefore unaffordable, especially for communities within the developing world (Sommer and Dantas, 2011).
According to Nathan and Cars (2014), misuse or overuse of antibiotics contributes most to antibiotic resistance by bacteria. When antibiotics are taken, bacteria are killed but a few may resist the drug. Therefore, frequent use or overuse of antibiotics contributes to an increase in the population of bacteria that are resistant to antibiotics. Notably, antibiotics are not effective in combating viral infections. However, some people use antibiotics for the common cold and other viral infections. Huh and Kwon (2011) explains that it is such misuse of antibiotics that contributes most to antibiotic resistance by bacteria. Therefore, the smart use of antibiotic drugs is the most effective solution to the problem of antibiotic resistance by bacteria, as demonstrated by (Dryden, Johnson, Ashiru-Oredope and Sharland, 2011).
Accordance to Freire-Moran et al. (2011), healthcare providers play an important role in preventing antibiotic resistance by bacteria. For instance, providers should refrain from prescribing antibiotics when they are not beneficial to patients. In addition, healthcare providers should prescribe antibiotics that are specific to the bacterial strain that is afflicting the patient (Sommer and Dantas, 2011). More importantly, patients should be encouraged to use prescribed antibiotics in accordance with the instructions of the physician in order to prevent misuse and the resultant resistance by bacteria (Dryden, Johnson, Ashiru-Oredope and Sharland, 2011). According to Nathan and Cars (2014), collaborations among patients, office staff, and other members of the community on the effective use of antibiotics are effective in mitigating misuse and the resultant development of resistance by bacteria.
Animal Industry and Farming
Antibiotics are routinely used by livestock producers. Huh and Kwon (2011) explain that animal producers give antibiotics to their animals with the goal of facilitating growth and helping them to survive unsanitary or crowded conditions. Freire-Moran et al. (2011) demonstrate that misuse of antibiotics by animal farmers contributes significantly to bacterial resistance. Notably, vancomycin and virginiamycin are commonly used as growth enhancers in cattle, chickens, and pigs (Dryden, Johnson, Ashiru-Oredope and Sharland, 2011). Nathan and Cars (2014) reveal that in addition to injection and oral administration of antibiotics, many farmers mix a small amount of antibiotics with animal feed for several days or months. Huh and Kwon (2011) show that feed dosage of antibiotics in animal farms provides the best conditions for the development of bacteria strains that are resistant to antibiotics.
Bergen et al. (2012) report that crop growers spray antibiotics on fruit trees with the goal of preventing or treating various crop infections. Freire-Moran et al. (2011) illustrate that after initial spraying; traces of antibiotics remain on crops, which contributes to the development of resistance by bacteria. Scientists report that antibiotic-resistant bacteria enter the food chain or spread from farms to humans. For example, reliable research evidence indicates that antibiotic-resistant bacteria can spread from farms to humans through direct contact with crops or animals, drinking of contaminated water, or consumption of meat (Dryden, Johnson, Ashiru-Oredope and Sharland, 2011). Possibilities of transfer of genes between human and animal bacteria have also been explored and reported by researchers (Sommer and Dantas, 2011).
The consequences of the transfer of antibiotic-resistant bacteria from farms to humans are widely reported in the research literature. For example, studies in the United Kingdom, Germany, France, Netherlands, and Ireland reveal that introduction and misuse of fluoroquinolone antibiotics in farms leads to the spread of antibiotic-resistant Salmonella to humans (Dryden, Johnson, Ashiru-Oredope and Sharland, 2011). Freire-Moran et al. (2011) demonstrate that vancomycin-resistant Enterococcus is linked to the use of avoparcin in farms to promote the growth of animals. The body of evidence on the spread of antibiotic-resistant bacteria across the supply chain is growing, as noted by Huh and Kwon (2011). Antibiotic-resistant developed in chickens and pigs is specifically reported to contribute most to the antibiotic resistance that spreads across the food chain to the general human population (Sommer and Dantas, 2011).
Freire-Moran et al. (2011) recommend that the treatment of animals with antibiotics should be under the supervision of veterinary officers. Supervision will ensure that farmers use antibiotics only to treat or control infections (Andersson and Hughes, 2014). In addition, farms should be inspected to ensure that animals are reared in good conditions. Nathan and Cars (2014) explain that reducing overcrowding within farms will minimize the need for antibiotics. In addition, farmers should vaccinate their animals to prevent infections, and therefore reduce the need for antibiotics. Sommer and Dantas (2011) argue that collaboration among veterinary services, public health programs, and farmers will promote and advance goals of mitigating bacterial resistance to antibiotics.
Andersson and Hughes (2014) assert that antibiotic resistance is an escalating problem that calls for the action of the government through the implementation of more robust action plans at local and national levels. For example, plans for improving the surveillance of infections caused by antibiotic-resistant bacteria should be implemented by the government (Nathan and Cars, 2014). Education programs targeting farmers should also be implemented to create awareness of the dangers of the inappropriate use of antibiotics in farms. The pharmaceutical industry also needs to be more aggressive in its research efforts in order to align drug development with the evolution of bacteria (Sommer and Dantas, 2011). Stimulation of research and development in the pharmaceutical industry will support initiatives for the mitigation of bacterial resistance to antibiotics, such as through the development of better antibiotic medications.
Conclusion
Antibiotics save millions of lives across the world every year due to their action in preventing, controlling, and treating bacterial infections. However, antibiotics are often misused by patients and farmers. Misuse of antibiotics is associated with negative effects, most of which are linked to bacterial resistance to antibiotics. Antibiotic resistance by bacteria makes it impossible to treat simple bacterial infections, which increases the suffering of patients and enhances the risk of complications. Misuse of antibiotics in farms, such as adding them to animal feeds to stimulate growth, provides to the spread of antibiotic-resistant bacteria across the food chain. Partnerships among public health departments, veterinary services, and farmers for improved farm conditions, vaccination, and appropriate use of antibiotics are recommended by researchers. Research gaps in the mitigation of the problem of antibiotic resistance should also be addressed by the pharmaceutical industry.
References
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Freire-Moran, L., Aronsson, B., Manz, C., Gyssens, I.C., So, A.D., Monnet, D.L. and Cars, O., 2011. Critical shortage of new antibiotics in development against multidrug-resistant bacteria—Time to react is now. Drug resistance updates, 14(2), pp.118-124.
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Nathan, C. and Cars, O., 2014. Antibiotic resistance-problems, progress, and prospects. New England Journal of Medicine, 371(19), pp.1761-1763.
Sommer, M.O. and Dantas, G., 2011. Antibiotics and the resistant microbiome. Current opinion in microbiology, 14(5), pp.556-563.
