RATIONAL USE OF ANTIBIOTICS

Antibiotics are powerful and effective drugs in the fight against infectious diseases caused by bacteria, and have saved millions of lives since their first appearance about 50 years ago. Yet now, more and more people are dying from infectious diseases that were curable but for which we no longer have the right treatment. This is because certain bacteria are transforming themselves and developing increasing resistance to antibiotics. While some resistant strains remain confined to specific regions, others are spreading rapidly and are creating a situation which is fast becoming a global public health problem. Though some scientists foresaw the development of resistant strains, nobody imagined they would develop and spread so rapidly. More than 80% of some of the most common bacteria, Staphylococcus aureus, are now resistant to penicillin and ampicillin.

In the developing countries, infectious diseases of bacterial origin are the leading causes of sickness and death, and are responsible for more deaths than all the parasitic infectious diseases put together and for more than those caused by noncommunicable diseases, including accidents, cardiovascular diseases and cancer. While many bacterial diseases, which mainly affect children, can be avoided through improved nutrition, vaccination coverage, sanitation, and access to safe drinking water, the need for antibacterial drugs still remains enormous.

New antibacterial products are appearing at an unprecedented rate. The prime cause of the rapid increase of resistant bacteria in both developing and developed countries is the abuse and inappropriate use of antibiotics. They therefore have to be used advisedly, in the right dose and for the right length of time.

Probably more than any other pharmaceutical products, antibiotics are seen as "magic bullets" capable of treating a wide range of ailments.

The problem of irrational use of antibacterial drugs is both complex and many-faceted. But whatever its complexity, it should not be underestimated because it has a harmful influence on the possibilities of successfully treating certain highly prevalent infectious diseases.

Policy on the rational use of antibiotics

A coherent policy should promote simple and inexpensive measures that could have a considerable effect on the optimal use of antibiotics. Such measure include.

* orienting the initial training and regular retraining of prescribers and dispensers so that they learn the best ways of effectively combating infectious diseases;

* providing simple and inexpensive equipment to laboratories so that they can give valid bacteriological information;

* improving the supply and distribution of antibiotics in accordance with the principles of an essential drugs policy, thus making drugs available at locally affordable prices;

* controlling information and marketing in such a way as to promote the most efficacious antibiotics and those best adapted to the local epidemiological situation;

* carefully studying cultural attitudes so that the right kind of education and information can be deployed to encourage people to accept the most appropriate treatments for each illness.

The rational use of antibiotics would help to limit as much as possible the appearance and spread of resistant strains, which in the long run threaten our chances of effectively controlling the infectious diseases.