Uncontrolled use of antibiotics. What does it threaten?

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WHO data for 2019 show that almost 5 million deaths were linked to antibiotic resistance. 1.27 million deaths were directly caused by this phenomenon, of which more than 250,000 are children under the age of 5.

Even now, 30% of deaths in the world from neonatal sepsis in newborns are caused by pathogens resistant to antibiotics.

The situation in Ukraine worsened after the full-scale invasion of Russia.

Here is a real life story. Serhiy Sulimovskyi is a doctor of the medical unit of the anti-tank artillery division who agreed to talk about this case. During his service in the Donetsk region, he contracted pneumonia, tests for COVID showed a negative result.

Serhiy himself immediately started taking antibiotics, which were supposed to destroy the causative agents of bacterial pneumonia. But the medicine didn’t work, and he got worse and worse. Serhii was evacuated to Dnipro, and from there to Kyiv. At the time of evacuation, he practically did not breathe on his own and was on oxygen therapy. Precious time was lost – by the time they began to select antibiotics capable of stopping the infection, more than 70% of the lungs were already affected.

Fortunately, the doctors managed to save Serhii’s life. He stayed in the hospital for more than a month, and due to his deteriorating health, he was discharged, and he returned to work as an obstetrician-gynecologist. But he still has difficulty breathing, even when walking.

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This is one of thousands of stories that can happen to anyone – both on the front and in civilian life.

Another step towards the development of antibiotic resistance is the widespread habit of “treating” acute viral diseases, influenza and COVID-19 with antibiotics. Antibiotics do not help to overcome viral infections, but they slowly “accustom” bacteria to themselves and make them resistant. Examples of such bacteria are pneumococcus (causing pneumonia, otitis, sinusitis) and staphylococcus aureus.

We are not “infected” with them from a sick person – they live in the nose and throat and on the skin of almost everyone, but they cause disease only in individual cases. A consequence of inappropriately frequent use of antibiotics is that these common bacteria are gaining strength and resistance to the drugs.

This means that more and more people will find themselves in a situation similar to the situation with our military doctor: first-line antibiotics do not work, and it is difficult to find an effective treatment, because there are fewer effective drugs against this infection. If we do not change approaches to prescribing and taking antibiotics, mortality and disability due to infections will increase.

Currently, the causative agents of the most common infections on the planet, such as: tuberculosis, gonorrhea, urinary tract infections, some types of intestinal infection, have already developed resistance to many antibiotics and continue to strengthen their positions. Once effective antibiotics will simply run out.

In order to slow down and stop this process, Ukraine joined the WHO Global System for Surveillance of Antimicrobial Resistance and Use, and is actively implementing the necessary changes.

This year, the Ministry of Health approved new standards for the use of antibacterial and antifungal drugs. According to them, only laboratory or symptomatically proven (if the doctor sees pus in the patient’s throat or wound, temperature 40) bacterial infection can be treated with antibiotics.

According to the international classification, all antibiotics are divided into three groups: access, observation and reserve. Antibiotics of the access group are drugs that act on the most common pathogens and are associated with a lower probability of developing resistance. These are antibiotics of first choice. Antibiotics in the observation group are associated with a higher probability of developing resistance. They are prescribed when first-line antibiotics do not work.

Antibiotics of the reserve group should be used exclusively to overcome pathogens that are resistant to many other drugs. These are the drugs prescribed in the extreme case of saving life and health, when nothing else is effective against the infection. If we prescribe these drugs “for every bee”, we will not have effective drugs against bacterial infections, and people will die from them by the thousands.

Whether this will happen or whether we can prevent it depends not only on the education and responsibility of doctors, but also on each of us. The main rule that must be strictly followed is to take antibiotics only as prescribed by a doctor, do not change the dose and do not stop taking them without consulting a doctor, even if you feel better.

In addition, there is another safe and very effective method to prevent infectious diseases. Unfortunately, it is often neglected by Ukrainians. This is vaccination. Vaccinate children according to the National Immunization Schedule, don’t forget that adults also need to be vaccinated every ten years against diphtheria and tetanus, vaccinate children and vaccinate yourself against coronavirus disease, because it can lead to pneumonia. If you can, get vaccinated against flu and pneumococcal infections. .

Only by strict adherence to the rules by doctors and pharmacists, as well as a responsible attitude of each of us to treatment, will we be able to stop antibiotic resistance and save human lives.

Victor Lyashko, Minister of Health, especially for UP. Life

Publications in the “View” section are not editorial articles and reflect exclusively the author’s point of view.