Kathmandu, November 23 -- An 11-year-old girl from the Chabahil neighborhood in Kathmandu was taken to Dr. Ganesh Rai's clinic, who prev...
Kathmandu, November 23 -- An 11-year-old girl from the Chabahil neighborhood in Kathmandu was taken to Dr. Ganesh Rai's clinic, who previously served as director at the Kanti Children's Hospital, because she was experiencing flu and a persistent cough. The girl's parents mentioned that their daughter did not improve, even after being given two antibiotics.
"A physician who visited a pharmacy close to their residence prescribed antibiotics within two days of the illness. When the condition remained unresolved, a different doctor prescribed an alternative antibiotic," stated Dr. Rai.
In the majority of instances, flu and coughs resolve within seven to ten days, and patients do not require antibiotics. However, patients and their family members often fail to comprehend this.
Antimicrobial resistance is becoming a major public health concern, described by health professionals as a "silent pandemic" within the nation. The situation has become so severe that most people in the country are unaware of its extent, as they mention.
We encounter numerous such cases daily," said Rai. "If the pattern of irrational antibiotic usage persists, with physicians prescribing life-saving medications unnecessarily or without proper consultation and pharmacies dispensing them without a prescription, it won't be long before antibiotics become ineffective entirely.
When the doctor outlined the situations where antibiotic use was truly necessary, the parents of the sick child were convinced. They expressed regret for using antibiotics without seeking professional advice and promised not to repeat such errors in the future, as reported by Rai.
Medical professionals and public health specialists in Nepal have long been highlighting the issue of improper antibiotic usage to the general population and relevant authorities. They mention that even though they have tried to educate people about the issues, the widespread use of antibiotics continues without any decrease.
The weight of the issues has grown over time," stated Dr. Anup Subedee, a specialist in internal medicine and an expert in infectious diseases. "Resistance has emerged even against new antibiotics that were introduced only a few years ago.
Although human use of antibiotics leads to resistance, the extensive application of these drugs in farming—particularly in raising animals and birds—can also be a contributing factor.
Medical professionals indicate that agricultural antibiotics play a role in the development of antibiotic-resistant bacteria in meat and poultry. Furthermore, these resistant microorganisms can be released from farms into the soil, groundwater, and surface water, resulting in the pollution of water sources utilized for growing crops and household use.
The World Health Organization stated that antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites undergo changes over time, leading to a loss of response to medications. This makes infections more difficult to manage and raises the chances of disease transmission, serious health issues, and mortality. Consequently, the drugs lose their effectiveness, and infections remain in the body, increasing the likelihood of spreading to others.
Although antibiotics are classified as prescription medications, they can be readily obtained without a prescription in Nepal. Numerous individuals purchase them without informing the pharmacists about their specific health issues. Pharmacists also rarely ask for details and often neglect to highlight the significance of finishing the entire course of treatment, which is one of the primary causes behind the increasing prevalence of antimicrobial resistance, as experts point out.
Second, in most cases, physicians prescribe antibiotics based on clinical diagnosis, prior to receiving laboratory test results. Specialists point out that antibiotics are ineffective when the infection is viral in nature.
As per a 2021 report from the Nepal Health Research Council (NHRC), just 32 percent of physicians and healthcare professionals have access to laboratories for antibiotic sensitivity testing. Out of these, only 49 percent of doctors suggest conducting sensitivity tests prior to prescribing antibiotics. This implies that only 16 percent of doctors prescribe antibiotics following such testing.
The research also indicates that over one-third—37.8 percent—of prescribed medications were antibiotics, exceeding the guidelines set by the World Health Organisation.
The research indicates that approximately one fourth (22 percent) of the outpatient patients did not complete a full course of antibiotics. Likewise, around 10 percent of the outpatients used antibiotics as a preventive measure, while eight percent took a higher dose of antibiotics for faster recovery.
Approximately 22 percent of individuals keep leftover antibiotics for potential future use when experiencing similar symptoms. Moreover, about 28 percent of outpatient patients reported purchasing antibiotics without obtaining a prescription from a doctor or healthcare professional.
The findings indicate that many patients are unaware that finishing a full antibiotic treatment is essential, and stopping early could reduce the drug's effectiveness in the future.
The NHRC research indicated that approximately 70 percent of farmers administered increasing amounts of antibiotics and used them more often to achieve quicker recovery for ill animals or poultry.
The research highlighted significant gaps in the understanding and access to national protocols for antibiotic prescription, as well as the systems for suggesting antibiotic resistance testing among professionals in both human and veterinary medicine.
Act Now: Protect Our Present, Secure Our Future" is a collective duty, according to the UN health organization in its statement. "As one, we can ensure antimicrobials remain useful and create a healthier, more eco-friendly world for future generations.
