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    Alarm over antibiotics

     



    Desk Report : Indiscriminate use of antibiotics poses a high risk of liver and kidney damages mostly among the country's rural population, medicine experts say.

    It also builds antibiotic resistance in human bodies, multiplying the extent of diseases that even can lead to death in extreme cases.

    If such resistance continues to develop, bacterial infections could go beyond treatment in future.

    Explaining the reasons behind irrational use of antibiotics, Kumar Bishwajit Sutradhar, senior lecturer of pharmacy department of Stamford University, said drug companies bribe a section of physicians both in cash and kinds.

    �Ultimate result is prescriptions of inappropriate or unnecessary and expensive medicines,� he said citing a study published in the UK-based journal Science Domain International on January 15 this year.

     

      Sutradhar and others conducted the study among 6,000 patients and 580 physicians, village doctors and pharmacists in rural areas of Dhaka and Rajshahi divisions in July to December 2012.

    While physicians must diagnose before prescribing antibiotics, 44 percent of them prescribe antibiotics for cold, fever and acute respiratory infections before diagnosis, he said.

    Doctors prescribe antibiotics in 61 percent suspected infection cases of patients who have been ill for seven to 10 days and only in 35.7 percent confirmed infection cases.

    The study titled �Irrational use of antibiotics and antibiotic resistance in southern rural Bangladesh: perspectives from both the physicians and patients� also reflects the situation of urban areas partly, Sutradhar added. 

     Patients too have negligence in this regard.

    Almost 50 percent patients stop taking prescribed antibiotics just after the symptoms disappear, while only 25 percent patients complete dosage. Also, 27 percent patients believe it is not always important to follow the prescription.

    Sutradhar said not completing antibiotics course means bacteria being not wiped out will attack human body in later stages.

    Of the patients missing a dose of antibiotic, only 6 percent consult the doctor immediately, and 51 percent take the next dose as per schedule, while 23 percent just double the next dose of the drug.

    �Unnecessary use of antibiotics can damage kidney and liver,� said Pharmacy Professor Dr Mohammed Rahmatullah at the University of Development Alternative.

    Painkillers like paracetamol and aspirin also affect lever and kidney, but antibiotics do it more than the others. Liver breaks up antibiotics, which then comes out of the body system through kidney.

    In this process, if one takes overdose of antibiotics, liver and kidney damage is the logical consequence, he said.

    �If liver damages permanently, its transplantation takes Tk 30-40 lakh. In failure of treatment, the patient has to face death.�

    A 2008 study by the American Gastroenterological Association (AGA) Institute found antibiotics to be the single largest class of agents causing idiosyncratic drug-induced liver injury (DILI).

    DILI is the most common cause of death from acute liver failure and accounts for approximately 13 percent of cases of acute liver failure in the US.

    According to the World Health Organisation (WHO), multi-drug resistant tuberculosis (TB) is 19 percent among the patients treated in Bangladesh where estimated TB incidence is 225 per 100,000 populations per year.

    �Irrational use of antibiotic poses a great danger, as it develops drug resistance faster than what a new generation drug takes to be developed,� said Dr Iqbal Arslan, professor of Biochemistry at the Bangabandhu Sheikh Mujib Medical University.  

    He blamed it on the counter sales of antibiotics, suggesting the government strictly prevent sales of antibiotics and painkiller drugs without prescriptions of the registered doctors by framing a law.

    Pharmacy Professor Dr ABM Faruque of Dhaka University said according to WHO guidelines, doctors must determine the nature of micro-organism before prescribing antibiotics. And, the medicines prescribed should be low-cost and available and have minimum side effects.

    But the guidelines are often ignored, he said.

    Contacted, Major General Jahangir Hossain Mollik, director general of the Directorate General of Drug Administration, said Bangladesh Medical Association (BMA) could motivate the doctors to be cautious about antibiotics prescription.

    On a section of drug companies bribing doctors for prescribing the drugs, Mollik said, �That sort of corruption you will find in all sectors.�

    Dr Iqbal Arslan, also secretary general of BMA, said apart from the physicians, the patients also should be educated so they don't misuse drugs, and stop advices of the drug sellers. the daily star

     

    Local Time :   0224 Hours, 27 April 2024

     



     
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