Consequences of antibiotics misuse
Prompt use of the right antibiotics or antimalarial for a patient infected with bacteria or Plasmodium respectively can make a big difference between cure, long-term illness or death. Unfortunately, the abuse and misuse of antimicrobials have caused antibiotics to lose their effectiveness at an increasing rate. The more we abuse antibiotics, the greater the chance bacteria will become resistant to them, and they can no longer be used to treat infections.

What is antibiotics abuse?
Antibiotics abuse refers to its overuse, underuse, wrong timing of dosing, incomplete dosing, dangerous combinations and more. Antibiotics abuse is so rampant in Nigeria because you can buy almost any medicines over the counter without prescriptions. Besides we have a lot of unfit drug stores at every corner, you have ‘mallams’ hawking them at motor parks, in buses, filling stations and more. So they are not just readily available, they are recommended in the wrong doses and combinations. These people are in business because we patronise them. The cost of this action is beyond comprehension. Antibiotics abuse and misuse are linked to so many chronic diseases as a result of its damaging effects on beneficial bacteria found in the body. These have dire consequences and manifest as weakened immune functions, vaginal discharge and itch, chronic diarrhoea, hormonal imbalance, eczema, insomnia and even mood disorders such as anxiety.
One common thing that happens is when we self-medicate, e.g., treat a cough caused by a viral infection, flu or a non-infectious reactive diarrhoea such as one caused by lactose intolerance, we kill the beneficial bacteria in the gut or the female genital tract.

Effects of antibiotics abuse
A] Antibiotic abuse causes a greater chance of destruction of beneficial bacteria in the gut, on the skin and the urinary tract of females. Destruction of essential gut flora may cause you to become malnourished and have multiple nutrient deficiencies and food intolerances because the roles of key gut flora include but not limited to:
• Controlling the population of bacteria that can cause infections
• Playing an active part in normal digestion and absorption of food by producing enzymes that aid in breaking down proteins, carbohydrates, and fats
• Helping the transportation of vital minerals, vitamins, water, and other nutrients into the bloodstream from the gut for use by the body
• Nourish the cells of the intestinal wall; these cells have the primary responsibility of digesting and absorbing food

Did you know certain types of essential bacteria are capable of manufacturing nutrients such as vitamins K2, B1, B2, B3 B6, B12, folic acid, pantothenic acid, and various amino acids?

This misuse of antibiotics upsets our gut health; it presents as either diarrhoea or vaginal itch and discharge because we have given room for the dangerous bacteria to thrive in the absence of the protective ones which keep them in check. What do we do when we have these symptoms? We take more antibiotics to treat! This antibiotic misuse kills more of the beneficial flora, and we later come down with some of the conditions mentioned above. A lot of times we do not remember this history of antibiotic overuse/abuse. For us women, if we had visited a public toilet within two weeks or more of this episode, we blame the discharge on toilet infection. This accusation is not true, but we will leave toilet disease as a topic for another day.

Allergies are now so common in our environment; they have been linked to antibiotic abuse which has distorted the gut bacterial population causing changes in digestion, nutrient production and more as stated above. Antibiotics abuse have also been associated with the marked increase in incidence obesity and chronic non-communicable diseases such as diabetes, high cholesterol and cancer, even if it is just research findings, wouldn’t it be great if we erred on the side of caution. If it turns out to be true, you would have protected yourself, but if not true, you have nothing to lose. Other effects of antibiotics misuse are bacterial infections not responding to agents they once were sensitive to; this is resistance.

B] Resistance
What is antibiotics resistance?
One of the significant consequences of antibiotic overuse is resistance. Antibiotic-resistant bacteria cause infections that increase levels of disease and death, as well as the length of time people, stay in hospitals.
• Antibiotic abuse may cause patients to become colonised or infected with resistant bacteria.
• As resistance in bacteria grows, it will be made more difficult to treat infection, and this affects patient care, besides very few new antibiotics have been developed in the past 2 – 3 decades.

What is causing this problem?
The inappropriate use of antibiotics is causing the development of resistance. Inappropriate antibiotics use includes:
• Not taking your medicines as prescribed
• Skipping doses of antibiotics
• Not taking them at regular intervals
• Saving some for later
• Sharing antibiotics with others

Inappropriate prescribing includes:
• Unnecessary prescription of antibiotics
• Improper use of broad-spectrum antibiotics
• Wrong selection of antibiotics
• The inadequate duration or dose of antibiotics

What causes antibiotic resistance?
Suboptimal treatment of an infection: any bacterium that survives an antibiotic treatment can then multiply and pass on its resistant properties.
There is our growing reliance on feeding antibiotics to livestock for growth promotion, weight gain and to treat, control and prevent disease. This increasingly common practice is a significant factor in the emergence of antibiotic-resistant bacteria. This antibiotic-resistant bacteria can get passed on to humans who eat food from treated animals.
Bacteria can adapt and find ways to survive the effects of antibiotics; this is antibiotics resistance, a Public health concern. Although malaria parasite is not a bacterium but a Plasmodium, I will use it to illustrate resistance to drive the close information home. Resistance is what happened to chloroquine due to over-treating, taking suboptimal or incomplete doses to treat malaria. For instance, if some of us feel any body pains or fever, without doing a test or assessing the pattern of illness, we treat for malaria whether or not we have malaria. Then for some of us who have confirmed we have malaria, after two days of medication most of us feel better and therefore stop treatment without completing our doses or do not even take it as prescribed but as we like or remember – these caused malaria parasites to become resistant to chloroquine. Now we have to take the newer more expensive combination antimalarial medications, and the unfortunate thing is, the parasites have also developed resistance to some of them. If we are not careful, this resistance will take us back to the years when there was no drug treatment for malaria! Who wants that to happen?
Another example will be tetracycline; it used to be the drug of choice for treating various infections, at the moment, and most bacteria that once responded to it are now resistance for the same reasons mentioned above. We need to play our role in preventing resistance. Apart from treatment of resistant bacterium being more difficult, the bacterium may spread to other people, and when antibiotics don’t work, the result can be:
• Longer illnesses, more complicated illnesses and more deaths caused by bacterial infections
• More doctor visits and the use of stronger and more expensive drugs
Examples of bacteria that have become resistant to antibiotics include the species that cause skin infections, meningitis, sexually transmitted diseases and respiratory tract infections such as pneumonia.

Solution? Antibiotics stewardship is the best option for preventing overuse and abuse.

What is Antibiotic stewardship?
Antibiotic stewardship is the appropriate use of antibiotics, and this can help preserve the effectiveness of current antibiotics, extend their lifespan and protect the public from infections by antibiotic resistant bacteria. We all have a role to play in antibiotic stewardship by taking the following steps:
• Consume antibiotics only as prescribed by your doctor – take the appropriate daily dosage and complete the entire course of treatment.
• If you have leftover antibiotics, throw them away, do not keep leftover antibiotics for another illness. They may not be the correct medicine and would not be a full course of treatment.
• Never take your friend’s or relatives’ antibiotics.
• Instead of pressuring your doctor to give you antibiotics, ask your doctor for advice on how to treat symptoms of infection.
• Practice good hand hygiene, especially after using the toilet, before eating, before preparing food and after handling fresh meat. Wash fruits and vegetables thoroughly, and keep kitchen work surfaces clean.
• Be sure you or your children receive recommended vaccinations.

With all these challenges of antibiotics, is it necessary to take them? Why are antibiotics necessary?
Antibiotics make possible many of the complicated surgeries that have become routine globally.
If we ran out of useful antibiotics, due to resistance, modern medicine would be set back by decades. Relatively minor surgeries, such as caesarian sections, appendectomies, could become life threatening as they were before antibiotics became widely available.
Conclusion
Let us make better use of antibiotics and help save this vital medicine from becoming obsolete. We are running out of drugs to treat evolving superbugs, due to the widespread and misguided use of antibiotics. Besides microorganisms are capable of sharing bits of themselves with each other to thwart even our most powerful last-line antibiotic.

Antibiotic overuse leads to drug-resistant ba, as well as entirely wipe out the body’s good bacteria, and this may contribute to the rise in chronic health conditions such as obesity, asthma, and cancer.
Farmers have discovered that animals fed small amounts of antibiotics, below the doses used to treat infections, gain more weight; this may also be contributing to obesity in humans. Beyond obesity, studies have shown that a child’s risk for inflammatory bowel disease increases with the number of courses of antibiotics taken.
Antibiotics may thus be a factor behind the unexplained rises in allergies, asthma and type 1 diabetes in children.
An out-of-balance bacterial environment in the digestive system may lead to inflammation, and inflammation may cause changes in cells that lead to cancer. More studies needed to corroborate these claims, but as consumers, let us play our part by avoiding antibiotic medications unless necessary. Unneeded antibiotics may lead to harmful side effects and future antibiotic-resistant infections.

I hope this was helpful. Please leave your comments and share this article with your friends and family. Thank you.

Wishing you good health and happiness,

Dr Nse

Author: Dr. Nse

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