Doomsday scenario with ‘superbugs’

From time to time, we get reports about emerging superbugs—microbes which are resistant to most antibiotics. This is no trivial problem which we can just brush aside. As the World Health Official (WHO) warns, the world may find itself in an era where there are no effective drug treatments for many infections.

Simple as it sounds, it looks pretty much of a doomsday scenario. That means that even common infections like respiratory tract or urinary tract can progress to potentially life-threatening infections because the bug can’t be controlled by any antibiotic anymore. Bacteria will have their grand heyday, and everyone—especially the elderly, the children and those with compromised immune systems—is ill-fated prey to these ogre microbes.

And this grim prospect was actually made possible by man-caused folly—which is the abuse, misuse or irrational use of drugs particularly antibiotics. We take antibiotics left and right as if they’re ordinary vitamins. For colds, low-grade fevers, and most viral infections we go to our friendly pharmacist, who would readily give us antibiotics like amoxicillin and cephalosphorin preparations, even without a doctor’s prescription.

We think that when the fever and other symptoms dissipate after a few days, it was because we took antibiotics, not realizing that most viral infections are self-limiting and they get well even without treatment. We think that we’ve saved some money in just getting the antibiotics over-the-counter, instead of consulting a doctor, not realizing the stiff price we have to pay later on because we have repeatedly spawned the seeds of antimicrobial resistance in our own bodies.

Even doctors should heed this call in preventing the accelerated development of antibiotics resistance. According to the WHO, there is an estimated 50 to 70 percent unnecessary prescribed antibiotics in many settings.

We’re happy to note that antibiotic manufacturers are also joining the fight to prevent the rapid development of antimicrobial resistance. During the recent World Health Day celebration, the Pharmaceutical and Healthcare Association of the Philippines (PHAP)—the association of big multinational firms in the country—pledged to do their share in preventing this specter.

They aim to contribute their share through ethical promotions of antibiotics, adherence to the highest standards of good manufacturing procedure (GMP) and development of new antibiotics.

Dr. Joven Tanchuco, medical director of PHAP member GlaxoSmithKline, which manufactures commonly prescribed oral and parenteral antibiotics, says that PHAP espouses the use of only the latest and most appropriate scientific data to support the rational use of antibiotics. The PHAP maintains a solid front in “condemning unethical promotional activities which induce inappropriate prescription of antibiotics.”

Dr. Tanchuco adds that PHAP members also adhere to the WHO standards of bioequivalence testing, particularly for antibiotics. He recommends stricter enforcement of existing regulatory policies and monitoring of compliance; and this control measure should be sustained not only during the approval process, but also as long as the drugs are available in the market.

It’s a known fact that the development of antibiotic resistance to old antibiotics is a natural phenomenon. There was a time when the good old penicillin was sufficient for most infections. Now it’s hardly being used because most microbes are resistant to it. Newer antibiotics have taken its place for most infections. Dr. Tanchuco and the PHAP acknowledge the need for continually developing new antibiotics proven by research to be effective against specific microbes. This takes some time though, so what we would like to prevent is a situation wherein microbes develop resistance faster than we discover newer antibiotics.

“We remain committed to the development of new treatments, including vaccines, particularly in tuberculosis, HIV and malaria,” Dr. Tanchuco says, assuring that other innovator companies have similar initiatives.

We just hope though that the newer effective antibiotics can be made affordable to the average Filipinos. The price of parenteral (intravenous or intramuscular) antibiotics sometimes cost the minimum-wage earner a whole month’s salary to complete a course of treatment—making it seem like a mirage when they need it. There has to be a way of merging availability and affordability of treatment.

This problem of developing antibiotic resistance has long been in the making. As I said in a previous article, it is a pathological brew we all helped prepare; and every time we take an antibiotic irrationally with or without a doctor’s advice, we continue to ferment this brew until it finally blows up. Let’s hope we don’t reach that point. May God have mercy on us that we don’t.