TEHRAN – The high consumption of antibiotics has increased significantly with the coronavirus epidemic over the last three years, which causes antimicrobial resistance.

As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat.

In 1928, at St. Mary's Hospital, London, Alexander Fleming discovered penicillin. This discovery led to the introduction of antibiotics which greatly reduced the number of deaths from infection. However, the first case of antibiotic resistance was reported in 1950.

To overcome these resistances, new antibiotics have so far been produced, but none of them could be exempted from this rule.

By 2050, microbial resistance is estimated to cause nearly 10 million deaths, and a cost of nearly $100 billion worldwide.The World Health Organization has divided antibiotics into three groups; the first one is antibiotics causing microbial resistance, the other group is antibiotics that have a high potential to create microbial resistance, and the third group is antibiotics that have not yet entered the phase of microbial resistance.

By 2050, microbial resistance is estimated to cause nearly 10 million deaths, a 2 to 3.5 percent reduction in the national GDP, and a cost of nearly $100 billion worldwide.

Amoxicillin, azithromycin, and cefixime are the three best-selling antibiotics in Iran, according to the surveys conducted by the Food and Drug Organization's health products monitoring office, the annual consumption of 60 Antibiotics in Iran is 2.8 times more than the average annual consumption in other countries.

World Antimicrobial Awareness Week was held from November 18-24 with the theme of “preventing antimicrobial resistance together”.

Overuse, misuse of antibiotics

Mohammad Hosseini, director of the Food and Drug Organization's health products monitoring office, told IRNA that misuse and overuse use of antimicrobial drugs has caused the phenomenon of microbial resistance.

Overuse of antibiotics can cause side effects that increase the treatment cost or cause irreparable physical damage to the user, if no action is taken in this regard, infectious diseases do not heal, he said.

Highlighting that the most effective way to reduce inappropriate use of antibiotics is accurate diagnosis of infection, he stated that a committee has been formed to monitor the prescription of antibiotics.

According to Hosseini, not treating the infected person due to microbial resistance, as well as the transfer of resistant microbes to other people and the spread of microbial resistance are two important issues that should be considered when taking antibiotics.

Nazli Nader, a medicine expert at Shahid Beheshti University of Medical Sciences, said that the problems in hospital infection control, the increased risk of other treatment procedures such as major surgeries, chemotherapy, organ transplants, joint replacements, and increased mortality due to infections, are other important problems of microbial resistance.

Citing the irrational use of antibiotics for viral diseases such as Covid-19, influenza, and colds, leading to an increase in microbial resistance, she stated that in viral diseases, we are only allowed to prescribe antibiotics when the patient has a bacterial infection at the same time.

Researchers estimated that in 2019, resistance to antimicrobials caused the death of 1.270 million people.

Top global public health threat

WHO has declared that antimicrobial resistance is one of the top 10 global public health threats facing humanity.

Lack of clean water and sanitation and inadequate infection prevention and control promotes the spread of microbes, some of which can be resistant to antimicrobial treatment.

The cost of AMR to the economy is significant. In addition to death and disability, prolonged illness results in longer hospital stay, the need for more expensive medicines, and financial challenges for those impacted.

Without effective antimicrobials, the success of modern medicine in treating infections, including during major surgery and cancer chemotherapy, would be at increased risk.

Antibiotic shortages are affecting countries of all levels of development and especially in healthcare systems.

New antibacterial substances are urgently needed. However, if people do not change the way antibiotics are used now, these new antibiotics will suffer the same fate as the current ones and become ineffective.

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