Antimicrobial resistance: A result of misuse of medicines

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Antimicrobial resistance: A result of misuse of medicines

Thursday, 23 November 2023 | Shobha Shukla/ Bobby Ramakant

Antimicrobial resistance: A result of misuse of medicines

Antimicrobial Resistance (AMR) is a problem driven by misuse and overuse of antimicrobial medicines, including antibiotics and antivirals

Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and become resistant to (or no longer respond to) medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death. As a result of drug resistance, medicines become ineffective, and infections become increasingly difficult or impossible to treat. That is why AMR ranks among the top ten global health threats worldwide.

“Antimicrobial Resistance (AMR) is a problem driven by misuse and overuse of antimicrobial medicines, including antibiotics and antivirals, and results in critical medicines losing effectiveness to treat infections,” said Thomas Joseph, Head, AMR Awareness, Advocacy and Campaigns, World Health Organization (WHO), at a recent pre-conference meet of 22nd International Conference on AIDS and STIs in Africa (ICASA).

“AMR is associated with 5 million deaths a year. Besides this, there is a huge burden of morbidity and healthcare expenditure that can affect household welfare severely. The World Bank estimates that Global GDP could fall by $1 to $3.4 trillion annually after 2030 due to AMR,” he added. The World Bank estimates that an additional 24 million people will be forced into extreme poverty by 2030 if no action is taken on AMR today.

Drawing attention to World AMR Awareness Week (WAAW) which is celebrated between 18-24 November every year, Thomas cautioned that “All stakeholders should realize that if we do not act now, we could go back to a pre-antibiotic era, when even simple infections become untreatable”.

Personal experience of surviving AMR

Vanessa Carter, an AMR patient survivor, One Health advocate, Chairperson of the WHO Taskforce of AMR Survivors, and founder of The AMR Narrative was one of the speakers at the 3rd Annual Global Media Forum on AMR, hosted by Global AMR Media Alliance in lead up to WAAW 2023. She shared her eye-opening personal experience of her battle with AMR

“In 2004, I was 25 years old. I had a severe car accident in Johannesburg, South Africa, and ended up in a hospital with a lot of massive injuries. I had been resuscitated on the side of the road, I was put on life support, I had multiple fractures in my face- a broken jaw and a broken nose- and also lost one eye. I also had a head injury, major abdominal injury, fractured pelvis, neck, and back injury. But the most complicated injuries were to my face, and it took me 10 years to recover from them, during which time I have had 4 different facial prosthetic implants,” said Vanessa.

But the worst was yet to come. Six years into the accident and after her fourth implant, one day, while getting into her car, Vanessa saw moisture seeping all over her face. It was pus oozing out from her 4th implanted prosthetic. She underwent emergency surgery, and the doctors did “debridement” and reconstructive surgery to fix up the damaged tissue. Two weeks later, the infection returned. She got more tissue reconstruction done. But the infection kept on returning and it worsened over time. This went on for the next 11 months during which she was kept under the care of several specialist surgeons.

Vanessa was eventually diagnosed with a highly antibiotic-resistant form of MRSA (Methicillin-resistant Staphylococcus aureus) infection. She could not undergo any more surgeries for one year, as the doctors had to wait for the tissue to recover. “I had to cover my face as I looked terrible. My face was very red, full of fluid and swollen. I could not wear my artificial eye. I could not go to fetch my child from school because the kids would get scared looking at me”, she recalls.

“I lost ten valuable years of my life between 25-35 years of age, being in and out of hospital, and not being able to look in the mirror without seeing a changed face. I nearly got a bloodstream infection and sepsis and almost died. But I am also living with a severe disability now- facial disfiguration which was partially caused by the accident but exacerbated by the fact that we could not treat this infection. When I learned about antibiotic resistance, it came as a surprise why it was not a common knowledge even though it is such a widespread global threat,” she shared in the forum.

This is first part of two-part series on AMR.

To be continued...

(Shobha Shukla and Bobby Ramakant lead the editorial team of Citizen News Service and are on the Board of Global AMR Media Alliance (GAMA) and Asia Pacific Media Alliance for Health and Development, APCAT Media; views are personal)

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