Since its discovery, antibiotics have helped to save millions of lives as they turned disease-killing infections into treatable ones. However, their successfulness has also caused one of the most acute health threats of our time, which is antimicrobial resistance (AMR). Although a lot of the discussion surrounding AMR centers on misuse by hospitals and the overuse in agriculture, the other contributing factor is much closer to home- that of leftover antibiotics in medicine cabins. These innocuous remnants contribute a lot towards resistance, complicating infections, extending, and treating them, making them more costly.
This paper discusses the roles of leftover antibiotics in antimicrobial resistance, the science that is resistant bacteria, and the reason why the misuse of such drugs intensifies the menace on a global scale.
Knowledge on Antimicrobial Resistance
It is necessary to be aware of the meaning of antimicrobial resistance before exploring the role of leftover antibiotics. Antimicrobial resistance is a process when bacteria, viruses, fungi or parasites adapt to resist the drugs that are aimed to kill them. When it comes to antibiotics, the resistant bacteria escape treatment and increase to a number of other people.
According to the World Health Organization, antimicrobial resistance is among the ten global health threats. Even insignificant infections can be transferred into a life-threatening state without effective antibiotics. Surgical procedures, cancer chemotherapy and organ transplant are not an exception and require the use of antibiotics to avoid infections. The compromise of their efficacy is disastrous to the healthcare systems all across the globe.
The Entry of Leftover Antibiotics in the Picture
Remaining antibiotics normally occur during the following circumstances:
- Unfinished prescriptions: Patients can cease their medication as soon as they get better, and the pills will remain unused.
- Physician over-prescribing: On some occasions the physicians over-prescribe either being cautious or because of patient persuasion.
- Self-medication and hoarding: There are people who store antibiotics in case they are sick in the future and they have the false belief that they will help in relieving a symptom such as cough, cold, or flu.
Although such practices might appear to be harmless, they bear huge implications. Whenever antibiotics remain and are consumed without due medical guidance, bacteria are exposed to partial or rather improper dosage. They do not get wiped out, but part of them manage to survive and become stronger.
The Particle Physics of Resistance
To realize why leftover antibiotics are harmful, it is best to consider the way resistance develops.
- Selective Pressure
The most susceptible bacteria die first because of antibiotics. In case the course is terminated prematurely or the dosage is insufficient, more robust bacteria remain alive. Such victims transfer their resistance to the next generations.
- Horizontal Gene Transfer
Resistance genes can be transferred to other bacteria even of different species. This allows the spread of defense mechanisms of a single resistant strain to whole populations of bacteria.
- Incomplete Eradication
In case leftover antibiotics are not used correctly, they can suppress the symptoms and still not eliminate the infection completely. This provides a condition in which bacteria is exposed to drugs as well as time to adapt.
The outcome is the increase of the number of resistant bacteria which diffuse within communities, hospitals, and across borders.
Real Life Implementations of Resistance
Already, the global effects of antibiotic resistance are being experienced:
- Methicillin-Resistant Staphylococcus aureus (MRSA): This pathogen, which was previously mostly hospital-acquired, has now emerged as a global community-acquired pathogen causing skin infections, pneumonia, and bloodstream infections. It is difficult to treat and is expensive because of its resistance.
- Drug-Resistant Tuberculosis (DR-TB): Tuberculosis is the infectious disease that claims the most number of people annually. MDR-TB is treated with long, toxic and expensive treatments with a reduced success rate.
- Gonorrhea Resistance: Neisseria gonorrhoeae is a bacterium that has acquired resistance to nearly all the available classes of antibiotics against it, increasing the risk of incurable sexually transmitted diseases.
These cases illustrate a bitter truth, since once bacteria become resistant there is no longer an easy way to treat them and the effects of these resistances are more than personal and spill to communities.
Why Leftovers Churn up the Crisis
The remaining antibiotics are especially hazardous due to a number of reasons:
- Encouraging Self-Medication
Citizens are inclined to use the old antibiotics without medical attention. They can bring them home because of such illnesses as the viral colds or flu that cannot be treated by antibiotics. This unwanted exposure promotes resistance in the absence of any advantage.
- Incomplete Dosages
Taking the remaining pills hardly gives a complete course of treatment. Partial treatment does not kill the bacteria but only renders them partially suppressed, providing them with an opportunity to evolve.
- Sharing Medication
There are families that share antibiotic leftovers amongst the family. Not only will this practice create a risk of resistance, but also it may result in damage when the drug is inappropriate in the illness or it could be very incompatible with other medications.
- Improper Storage
Home based antibiotics can deteriorate with time making them ineffective. Poorly handled doses of expired drugs also cause resistance as effectively as untaken courses.
The Cost of Resistance
The most terrifying aspects of antimicrobial resistance on the global level include:
- Higher Deaths: Resistant infections are leading to hundreds of thousands of deaths every year and it has been estimated that with current trends it is expected to cause up to 10 million deaths yearly by 2050.
- Increased Healthcare Costs: Resistant infections are more expensive and need to be in hospitals longer, more medication and use of tests.
- Economic Burden: The world bank estimates that AMR would result in an economic harm globally that is just as severe as the 2008 financial crisis.
To the individuals, the price is very personal, i.e. prolonged illness, lack of treatment options and increased medical bills.
Stopping the Transmission of Resistance at Home
All families have a contribution to make towards the battle against antimicrobial resistance. Practical steps include:
- Complete Prescriptions
Never stop taking the entire amount of antibiotics as soon as the symptoms are relieved even before the medicine has finished.
- Avoid Self-Medication
Do not take anything that is left behind or supposed to be used by another person. Use of antibiotics must be under the care of a professional medical practitioner.
- Proper Disposal
The unused antibiotics are to be returned to the pharmacies or got rid of through the safe collection programs. Washing them down the toilet or dumping them in the garbage helps in environmental pollution and suppression of soil and water bacteria.
- Raise Awareness
Professional education of family members on the harms of remaining antibiotics will assist with reducing casual use and enforce the good habits within communities.
Strategies against AMR in the Whole World
As much as personal efforts are important, the world needs to collaborate in addressing the problem of antimicrobial resistance. Key strategies include:
- Stewardship Programs: Hospitals and clinics are also introducing antibiotic stewardship programs in order to make sure that drugs are only prescribed when needed and in the appropriate doses.
- Surveillance Systems: Resistance patterns are monitored to aid the quick response of the health authorities in responding to any arising threat.
- Research and Development: Innovative antibiotics, vaccinations, and alternative treatment are in dire need in order to keep up with the changing bacteria.
- Public Education: Educational campaigns inform of the risks of abuse and the necessity to take prescription to the end.
The Policy and Regulation Role
The government can deal with AMR by:
- Indicative control of the sale of antibiotics to avoid over-the-counter sales.
- Incentive in the creation of novel antibiotics.
- Empowering healthcare systems in order to prevent wrong diagnosis and unsuccessful prescribing behaviors.
- Knowing to work in cooperation with other countries in tracking resistance and sharing data.
Unless there is a concerted effort, the abuse of antibiotics, such as those that are left at home, will keep on a decade or so of medical advancement.
Conclusion
Unused antibiotics might appear like a minor domestic problem, but when using them incorrectly, it may add to one of the most significant epidemiological crises of the modern era antimicrobial resistance. Every half-complete course, out of date pill, or self-administered dose is a new firebrand to the spreading of the resistance of bacteria which is sweeping the world.
Both individual accountability and group action are necessary in the solution. People can do a lot by filling in the prescriptions, not taking on self-medication, and disposing of the leftovers in a safe way. Meanwhile, healthcare professionals, policymakers and international organizations should reinforce stewardship, invest in new treatment and increase awareness in the population.
The war against AMR is not a struggle over the maintenance of power of antibiotics but the resistance of the entire basis of modern medicine in the future generation.
