Antibiotics are medicines that fight against bacterial infections, killing the bacteria or making it difficult for the bacteria to multiply. Unfortunately, with the good comes the bad, and now we are facing a reality where antibiotics are overprescribed and misused. Infections caused by multi-drug resistant bacteria are on the rise, and antimicrobial resistance is a major challenge to healthcare systems. If this trend of overprescribing antibiotics continues, antibiotics will become less effective and may no longer be life-saving. Radical change is needed to stop the misuse of antibiotics.
In this article, we will look at the types of antibiotics available, what they are used for, why they are being misused, and what can be done to rectify this.
What are antibiotics?
Antibiotics are powerful, lifesaving medicines that treat bacterial infections. Antibiotics can successfully treat many conditions, from skin and soft tissue infections to strep throat to UTIs and even Anthrax. They don’t work against viral infections, like colds and flu. Antibiotics can be taken in a few different ways; as pills or capsules for mild to moderate infections, intravenously (a drip or injection) for more serious infections, and topical antibiotics which can be applied as creams or drops.
Why are antibiotics being misused?
Given the massive international concern regarding the misuse and over-prescription of antibiotics, a lot of research has gone into discovering why this is happening. Multiple studies have found that most of the misuse of antibiotics occurs at the primary care level, in other words, the first medical professional you see when you are ill, most usually your General Practitioner (GP). Around 80 – 90% of all antibiotic prescriptions are written out by primary care practitioners, and the most common condition these antibiotics are prescribed for are respiratory tract infections (RTIs). Most RTIs are, however, caused by viruses, which means that antibiotics have no role in treating them.
So, why are antibiotics prescribed for up to 88% of RTI cases? There are a few factors involved:
- Healthcare providers: Primary care physicians often lack expertise or experience, or have limited time to treat patients. They could be uncertain of the diagnosis and prescribe antibiotics to be on the safe side, or they’re just doing what they have always done.
- Patient expectations: Patients often believe that antibiotics will help them get over colds and flu quickly because they are powerful. They put pressure on their primary care physician to prescribe the antibiotics and the GP, wanting to keep the patient, may, do what is asked of them.
- Healthcare systems: In many countries, antibiotics are not sufficiently regulated, meaning you can be on any number of courses of antibiotics and there is no system in place to flag overprescription. There is often a need for more education and resources to keep primary healthcare workers up to date with international research.
What factors contribute to antimicrobial resistance?
Bacteria, like other living organisms, adapt to the surrounding environment. One of the ways they adapt is by changing the way they interact with medication. The bacteria may become more resistant to antibiotics, or even become able to destroy them. Once a bacterium has mutated in this way, it can multiply more effectively and even transfer its resistance to different bacteria.
Antibiotics being prescribed “just in case”, or for viral infections attack the helpful bacteria in your body i.e. harming the gut microbiome which weakens the immune system. Taking antibiotics unnecessarily also stresses other bacteria already present and not causing disease, allowing these bacteria to develop antimicrobial resistance (AMR). When antibiotics are prescribed and the course is not completed, acquired AMR properties can be spread among harmful bacteria. Other factors like the extensive use of antibiotics in agriculture contribute to antimicrobial resistance.
Previously, new antibiotics were being developed all the time, so if an infection was resistant to one, another antibiotic would come along to take its place. Now, the rate at which new antibiotics are developed has slowed down considerably, and we face the very real problem of antibiotic resistance.
What are the effects of antimicrobial resistance?
In 2019, 9 500 people died in South Africa due to AMR. A further 39,000 deaths were associated with AMR, meaning that the death was due to a drug-resistant infection, but it is not known if AMR was the cause.
The World Health Organisation (WHO) estimated that AMR was directly responsible for 1.27 million global deaths in 2019, and contributed to 4,95 million. WHO has called AMR one of the top global public health and development threats. In addition to death and disability, AMR could result in $ 1 trillion in additional healthcare costs by 2050.
AMR can also mean more serious illnesses with longer recovery times and more frequent hospital stays, all of which can mean expensive treatments. Routine treatments become dangerous when antibiotics don’t work. Things like setting bones, operations and treatment of trauma all need antibiotics that work to be successful.
Enter antimicrobial stewardship.
Antimicrobial stewardship refers to a set of actions which promote responsible use of antimicrobials. This aims to prevent the overuse, misuse and abuse of antibiotics so that the effectiveness of these life-saving medicines can be preserved. To slow AMR, we must cut out the unnecessary use of antibiotics.
As a consumer, you can contribute to antimicrobial stewardship if you:
- Avoid pressuring primary care providers into giving you antibiotics. Ask for advice on symptomatic treatment first, if possible.
- Use antibiotics only as prescribed by your primary care provider. Do not save antibiotics for later, and always finish a course as directed.
- Never take antibiotics prescribed for someone else.
- Wash your hands! We interact with bacteria daily, and when we touch our nose, eyes or mouth with unwashed hands, we can easily transfer bacteria.
- Make sure your food is safe. Wash your hands before preparing food and before eating. Cook your food to a safe internal temperature to lower your risk of getting a bacterial infection from food.
A.Vogel Echinaforce plays an important part in the conservation of antibiotics. RTIs are one of the main reasons antibiotics are overprescribed and misused. In order to conserve antibiotics, the first and most obvious way to deal with misuse is to address the issue of RTIs, the greatest reason for their use in the first place.
This can be done by:
- Preventing RTIs
- Managing RTIs better
- Preventing secondary bacterial infections
A.Vogel Echinaforce does all of the above.
When using A.Vogel Echinaforce, RTIs are less likely to make it to the stage where antibiotics are prescribed incorrectly, or needed. A.Vogel Echinaforce is both a prevention and a treatment for colds and RTIs.
A.Vogel Echinaforce is the most extensively researched, and scientifically proven Echinacea product on the market. Made exclusively from freshly harvested Echinacea purpurea, it has a stronger antibacterial and antiviral effect than those made from dry plant extracts.
A.Vogel Echinaforce has been proven to reduce colds and RTIs when used as a preventative measure. When used to treat adults who already have a cold or RTI, A.Vogel Echinaforce has been shown to reduce fever days and support a reduced duration of illness by empowering your immune system to heal you. It has also been shown to significantly reduces viral load, which correlates with milder illness. A.Vogel Echinaforce also reduces RTI complications such as secondary bacterial infections and results in 76% fewer antibiotic prescriptions for children with RTIs.
To learn more about the misuse of antibiotics and ways to prevent this, listen to this eye-opening podcast featuring our A.Vogel South Africa team.
A.Vogel Echinaforce is available as drops, tablets, as a throat spray, and as chewable tablets for children.
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A.Vogel Echinaforce Drops Adults and children over 12 years: Acute dose: 20 drops 5 times daily. Prevention dose: 20 drops up to 3 times daily. Children 4-12 years: Acute dose: 10 drops 5 times daily. Prevention dose: 10 drops up to 3 times daily. Children 1-4 years: Acute dose: 1 drop per age five times daily. Prevention dose: 1 drop per age up to three times daily.
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A.Vogel Echinaforce Tablets Adults and children over 12 years: Acute dose: 3 tablets three times daily. Prevention dose: 3 tablets up to twice daily. Children 6-12 years: Acute dose: 1 tablet 5 times daily (as split doses). Prevention dose: 1 tablet up to three times daily (as split doses).
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A.Vogel Echinaforce Junior Tablets Children 2-4 years: Treatment dose: Chew 1 tablet 3-5 times daily (as split doses). Prevention dose: Chew 1 tablet up to two times daily (as split doses). Children 4-12 years: Treatment dose: Chew 1 tablet five times daily (as split doses). Prevention dose: Chew 1 tablet up to three times daily (as split doses). Adults and children over 12: Treatment dose: Chew 2 tablets five times daily (as split doses). Prevention dose: Chew 2 tablets up to three times daily (as split doses).
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Vogel Echinaforce Sore Throat Spray Dosage: [1 spray = 0.22ml] Adults and children over 12 years: 2 sprays 6-10 times daily. Children 4-12: 1 spray 6-10 times daily.
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A.Vogel Echinaforce Forte Adults and children over 12 years: Acute dose: 1 tablet three times daily. Prevention dose: 1 tablet up to twice daily. Children 6-12 years: Acute dose: 1 tablet twice daily. Prevention dose: 1 tablet daily.
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Find out more about A.Vogel Echinaforce and your immune system here.
Listen to the podcasts here: Antibiotic Misuse
Reference
- (No date) The burden of antimicrobial resistance (AMR) in South Africa. Available at: https://www.healthdata.org/sites/default/files/files/Projects/GRAM/S__Africa_0.pdf (Accessed: 03 June 2024).
- Antibiotic Guardian (no date) Antibiotic Guardian. Available at: https://antibioticguardian.com/ (Accessed: 03 June 2024).
- Antibiotics: Are you misusing them? (2024) Mayo Clinic. Available at: https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/antibiotics/art-20045720 (Accessed: 03 June 2024).
- Antibiotics: How they work, uses, side effects and how to use (no date) Medical News Today. Available at: https://www.medicalnewstoday.com/articles/10278 (Accessed: 03 June 2024).
- Master, W. (2023) Preparing for cold and flu season with Dr Naude, Living Naturally. Available at: https://livingnaturally.co.za/articles/general-healthcare/preparing-for-cold-and-flu-season-with-dr-naude/ (Accessed: 03 June 2024).
- professional, C.C. medical (no date) Antibiotics: When you need them and what to expect, Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/treatments/16386-antibiotics (Accessed: 03 June 2024).