16 JUNE 2014, Kathmandu – Why does the curable diseases also spread through out the world? Why has our part of the world is becoming hot bed of spreading super bugs? There are hundreds of ways we can kill the viruses but they are not in control but they are spreading rapidly, the main reason could be the over use of such medicine that we use for curing illness.
A recent Study says the reason for the spread of antibiotic-resistant bacteria is the over-use of antibiotics, poor hand hygiene in hospitals, and the large population of migrant workers.
The middle east, like many other parts of the world, is becoming a hotbed of super-bugs.
The warning was delivered by a study last summer and since then, the peril has been escalating.
The research, conducted by Hosam Mamoon Zowawi at the University of Queensland, Australia, says the reason for the spread of antibiotic-resistant bacteria is the over-use of antibiotics, poor hand hygiene in hospitals, and the large population of migrant workers who could have contributed to the spread of the bacteria.
The first systematic review of literature on antibiotic-resistant bacteria in the Gulf Cooperation Council (GCC) states — Saudi Arabia, the United Arab Emirates, Kuwait, Qatar, Oman and Bahrain — found a particular strain of potentially deadly super-bugs, bacteria that are resistant to the carbapenem group of antibiotics and kill up to half of infected patients, has increased up to 90 per cent over the past two decades.
The World Health Organisation’s first global report on the phenomenon, Antimicrobial Resistance: Global Report on Surveillance, released on April 30 this year, says antibiotic resistance in bacteria “is happening right now in every region of the world, and has the potential to affect anyone, of any age, in any country”.
“Without urgent, coordinated action by many stakeholders, the world is heading for a post-antibiotic era in which common infections and minor injuries which have been treatable for decades can once again kill,” it adds.
“By following the practice of popping pills today, we may be creating a drug-resistant monster for tomorrow,” says Dr Ashraf El Houfi, chairman of Dubai Hospital’s infection control committee.
Overuse of antibiotics in hospitals is also contributing to the birth of the super-bugs.
“Bacteria resistance is growing more than we are able to produce antibiotics,” Dr El Houfi says.
Misuse of antibiotics in the UAE is a cause for concern since one can walk over to a pharmacy counter and buy medicines without a doctor’s prescription.
The University of Queensland study identifies unique risk factors that could have contributed to the rise and spread of hospital- and community-acquired infections across GCC states, with the unnecessary use of antibiotics standing out as a particular risk.
Drugs are not candies
Antibiotics are easy to come by in Dubai, even those that are not supposed to be available over the counter.
Media visited a cross-section of drug stores to discover that not one pharmacist asked for a prescription before parting with medicines like Augmentin, Ciprobay and Amoxil.
At a pharmacy at the exit of the Financial Centre Metro station, the pharmacist just wanted to know whether we wanted the drugs as pills or in liquid form. Ciprobay was out of stock, but the other two were readily available.
At a well-known pharmacy at a shopping Mall, the white coat-wearing head pharmacist, asked if they ever require a prescription, said customers are asked about the medicine they want to buy to make sure it is for the right reason.
“Our job is to tell you, if you’re buying antibiotics for a sore throat, that you should instead buy lozenges and gargle… Antibiotics can harm your body. They’re not candies to be popped.”
The head pharmacist said that in 2003-2004, when he was in Al Ain, the rule that a prescription was needed to buy medicines was followed more stringently.
At another pharmacy in Dubai Marina, the pharmacist admitted that they don’t usually ask for a prescription.
However she added that they keep records of the sale of stronger drugs, the ‘semi-controlled’ and ‘fully controlled’ ones.
Stronger medicines will also not be sold without a doctor’s prescription.
The pharmacist also said that once every couple of months, government inspectors come to inspect and take inventory of the sale of strong drugs.
“Super-bugs are born and grow from the irrational use of antibiotics and it’s clear from our research that active guidelines must be enforced to restrict their use in the GCC region,” Zowawi says in his study.
Although non-prescription sale of antibiotics is illegal in the GCC states, 68 per cent of pharmacies in Abu Dhabi, 78 per cent in Riyadh and 87 out of 88 pharmacies included in a study in Saudi Arabia sold them without a prescription.
Researchers also found that poor hand-hygiene compliance in hospitals and the region’s large population of migrant workers could have contributed to the spread of antibiotic-resistant bacteria.
“The emergence of super-bugs can be explained as the survival of the fittest,” says Dr El Houfi. “Bacteria are smart, you see. Due to the overuse of antibiotics, they tend to mutate… following which the existing antibodies will no longer work.”
A variety of mutations are happening every second, he adds. “Antibiotics are becoming increasingly useless.”
Time to act
The solution is simple and the message is clear.
“Stop overusing antibiotics. This will decrease the mutations and the natural bacteria will do their work,” says Dr Ashraf El Houfi, chairman of Dubai Hospital’s infection control committee.
He feels all prescriptions should be regulated.
“A physician should stamp and sign his prescription. This will control the unnecessary use of antibiotics.”
Interventions are needed to combat the medical disaster facing the GCC states.
Hosam Mamoon Zowawi, the researcher at the University of Queensland, Australia, whose study says the Middle East is becoming a hotbed of super-bugs, says health agencies across the Gulf states are taking serious action to stop the emergence and spread of antibiotic-resistant germs.
“Improving basic infection control precautions like hand-hygiene, and prohibiting the availability of antibiotics without a prescription should also be mandatory, particularly in conjunction with a mass education campaign about antibiotic use,” his study recommends.
Zowawi, who is vying for the Rolex Award for Enterprise, hopes his research will encourage more hospitals in the GCC to educate the public and implement a surveillance system to keep track of antibiotic-resistant microbes.
The Dubai Hospital has already set up an antibiotic review committee that checks the dosage given to patients and monitors the prescriber.
The pharmaceutical industry is racing against time to develop new drugs to fight the mutant microbes.
“Developing medicines is a very expensive process and we are running out of formulas and drugs,” says Dr El Houfi.
Dr Ziad Muhammad Al Saadi, a general practitioner from Medcare Hospital, Dubai says there are several reasons behind the misuse of antibiotics.
“Some doctors are prescribing sooner than they are supposed to or the drug may not be correctly indicated,” he explains. “In some instances, patients are buying drugs over the counter or already have them at home.”
Sometimes patients pressure doctors to prescribe certain medicines. “Patients do not have the required medical knowledge. In such cases, a doctor should explain clearly.”
At times patients do not respond to emergency treatment because they were given a lot of antibiotics.
“This is a long battle… as long as we live,” Dr El Houfi says.
We Suggest to those who have may have minor illness and approaching to a pharmacy and ask for the Medicine that some friend suggested or you have used in the past could be dangerous to you and may help to increase the super-bug that you are infected to the whole community. Take formal prescription from a doctor which in many gulf countries are mandatory health insurance policy enforced by the authority for your safety and better health, take advantage of the rule and suggestion by the doctor.