Since the discovery of Penicillin in 1928 by Alexander Fleming, antibiotics have continued to play a critical role in healthcare. Not only are they used to treat infections caused by various strains of bacteria, but they are also used to prevent bacterial infections during surgery and in the event of accidents.
However, these life-saving medications are increasingly becoming less effective as antibiotic resistance continues to be on the rise. According to the Centre for Disease Control (CDC), antibiotic resistance is the ability of bacteria to resist the drugs (antibiotics) designed to kill them.
The resistance develops mainly as a result of the misuse or overuse of antibiotics. Antibiotic resistance results in the deaths of more than 35,000 people annually in the United States alone. However, there are no available studies in Nigeria that define the extent of antibiotic resistance, although data on antimicrobial resistance (AMR) rates of disease-causing organisms provides a rough proxy.
Worldwide, the World Health Organisation (WHO) estimates that antimicrobial resistance kills more than 700,000 people every year, a disturbing number that could rise to 10 million by 2050. A situation analysis on antimicrobial use and resistance in Nigeria released by the federal ministries of health, agriculture, and the environment in 2017 has shown high resistance rates of 70% – 100% to some antibiotics in certain states of the country.
In a country where infectious diseases are a major cause of morbidity and mortality, especially among children, this figure is of great concern. For instance, studies on samples from 120 children under five years of age from South-South Nigeria reported 100% resistance to penicillin and cotrimoxazole antibiotics. To commemorate the 2019 antibiotics awareness week, here are a few ways the rising scourge of antibiotics resistance can be halted.
Nigeria has health regulatory agencies such as, the Pharmacists Council of Nigeria (PCN) and National Agency for Foods, Drugs Administration and Control (NAFDAC), that has the responsibility of regulating the entire drug value chain, including antibiotics.
These agencies ensure the rules are adhered to in the manufacture, distribution, handling, and storage of drugs. Yet the powers of the agencies have not been applied consistently, especially in the areas of distribution and handling. This has resulted in the chaotic open drug markets across the country.
From Onitsha to Kano, medications including antibiotics which ordinarily require the prescription of a trained and licensed healthcare provider are sold in trays and wheelbarrows on streets and market squares, mostly by individuals who have not undergone any form of medical training. Because of the nature in which they are displayed, the medications are also exposed to the scorching sun, which often results in them losing their potency.
In communities and neighborhoods, some patent and proprietary medicine vendors (PPMV) and community pharmacists prescribe and sell antibiotics to residents without carrying out the required tests. PCN and NAFDAC must ensure untrained and unlicensed individuals do not have access to the purchase of any medication, not only antibiotics.
The major open drug markets across the country must be regulated. Pharmaceutical manufacturing and distributing companies must be made to only sell their medication to licensed retailers and strict penalties must apply to violators. Professional associations like the Pharmaceutical Society of Nigeria (PSN) and the Association of Patent Medicine Vendors (APMV) should also be made to regulate their members to only dispense antibiotics when necessary tests are performed, and prescriptions given to the patients.
Health workers at all health facilities must strictly adhere to the rationale prescription of antibiotics.