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Bug-fighting drugs are overused in many countries



Amoxicillin is the most misused antibiotic in the world.

There are disparities in the use of antibiotics in the world, with some countries overusing antibiotics, while others lack sufficient access to the medicines, a new report by the World Health Organisation has shown.

The report, which collated data on antibiotic consumption for human healthcare from 65 countries, shows there are wide differences in consumption of antibiotics in different countries.

Using a measurement called a defined daily dose (DDD) – the average dose a patient needs every day – to compare drug consumption in different countries, the report showed that the country with the lowest rate of antibiotic use is Burundi which has a rate of four defined daily doses (DDD) per 1,000 inhabitants per day.

In East Africa, Sudan and Tanzania had the highest antibiotic consumption rates of 33 and 27 daily defined doses per 1,000 people.

Globally, the country with the highest rate of antibiotic consumption was found to be Mongolia, with a rate of 64 DDD.

“Overuse and misuse of antibiotics are the leading causes of antimicrobial resistance. Without effective antibiotics and other antimicrobials, we will lose our ability to treat common infections like pneumonia,” said Dr Suzanne Hill, director of the Department of Essential Medicines and Health Products at the WHO.

Antibiotics are often wrongly prescribed for viral infections like colds and flu where they have no benefit, and half of all doses are given to livestock for growth. Last year, the World Health Organisation published a list of 12 bacteria, which pose the greatest threat to human health because they are resistant to antibiotics.

The list was drawn up in a bid to guide and promote research and development of new antibiotics to address growing global resistance to antimicrobial medicines.

Deemed a medical marvel for transforming modern medicine by treating and preventing bacterial infections, antibiotic are losing their magic and becoming ineffective against infections, because the drugs are routinely prescribed for infections they do not treat, or for which they are not needed.

“More than 70 per cent of antibiotics prescribed are either given unnecessarily or used improperly,” says Prof Samuel Kariuki, Director of the Centre for Microbiology Research at the Kenya Medical Research Institute.

Antibiotics are key in preventing pre- and post-surgery infection, and since most cancer treatments suppress the body’s ability to respond to infections, antibiotics, antifungals and antivirals help to keep people alive as they receive routine cancer care.

While antibiotics play a crucial role in the health sector, they are now failing to do what they were designed to do.

Drug-resistant infections are already responsible for an estimated 700,000 deaths every year. If no action is taken, they are expected to kill 10 million people annually by 2050.

The WHO report found that amoxicillin and amoxicillin/clavulanic acid – first or second-line treatments for common infections – are the most frequently used antibiotics worldwide. But the report also found that some third-line treatments, which it urges should be used with caution, are being consumed at high levels.

“Reserve” antibiotics, which should only be used as a last resort for treatment of specific infections caused by multi-drug resistant bacteria, account for less than two per cent of total antibiotic consumption in most high-income countries and were not reported by most low- and middle-income countries.

This may indicate that some countries may not have access to these drugs that are necessary for treatment of complicated multidrug-resistant infections, the report warns.

“Findings from this report confirm the need to take urgent action, such as enforcing prescription-only policies, to reduce unnecessary use of antibiotics,” added Dr Hill. The WHO estimates that only 50 per cent of antibiotics are used correctly and a huge number of prescriptions for antibiotics are not necessary.

The report was released as part of the annual Antibiotic Awareness Week, which aims to increase awareness of antibiotic resistance and to encourage best practices among the general public, health workers and policy makers to avoid the further emergence and spread of antibiotic resistance.