Combatting Superbugs; Some Innovative Ways To Fight Antimicrobial Resistance -By Bashir Abdulhayat

Antimicrobial resistance is not a distant threat; It is a present reality. originally occurs when microbes evolve and adapt to resist the effects of medications designed to treat infections. We are facing a situation where the very drugs that have been our best in the fight against infections are becoming less effective.

Therefore, for better understanding of the matter; we need to know what are Antimicrobials? They are medicines used to prevent and treat infections caused by microorganism in humans and animals. The more people misuse antimicrobials, the more likely the resistance will happen. Sometimes people used antibiotics when they do not really need to use them.

However, to understand the gravity of antimicrobial resistance (AMR), let us first recognize the importance of antimicrobials. They are our front line of defense against infections, essential in medical procedures, surgeries and treatments like chemotherapy. The implications of losing this defense are profound.

Some examples of Antimicrobials are as follows:
Antibiotics/antibacterials, tetracyclines, penicillins
Antivirals; acyclovir, abacavir
Antifungals, ketoconazole, fluconazole
Antiparasitic, ivermectin, praziquantel etc.
Moreover, it is very importance to briefly explain how the Resistance happens. Antimicrobial resistance involves genetic mutations and the transfer of resistant genes among microbes. Additionally, the misuse and overuse of antimicrobials contribute significantly to this growing challenge. It’s a complex interplay of biology and human behavior.

ANTIMICROBIAL RESISTANCE, A GROWING CRISIS IN NIGERIA AND WAY FORWARD

Antimicrobial resistance (AMR) has emerged as a critical and escalating crisis in Nigeria, posing significant challenges to public health, healthcare systems, and socioeconomic development. This phenomenon, characterized by the ability of microbes to resist the effects of antimicrobial drugs, particularly antibiotics, is fueled by a complex interplay of factors unique to the Nigerian context.

One of the primary contributors to the growing crisis of AMR in Nigeria is the pervasive and often inappropriate use of antibiotics. Over-the-counter availability of these drugs without prescription and inadequate regulation exacerbate the situation.

Patients, sometimes lacking access to proper medical advice, may self-prescribe or use incomplete courses of antibiotics, inadvertently fostering an environment conducive to the development of resistant strains of bacteria.
Likewise In the agricultural sector, the use of antibiotics for growth promotion and disease prevention in livestock is a common practice. This agricultural application of antimicrobials contributes to the spread of resistance genes in the environment, posing a direct threat to human health through the food chain.

Nigeria’s healthcare infrastructure faces substantial challenges, including limited access to quality healthcare in almost all the regions. Infections are often treated empirically due to inadequate diagnostic facilities, leading to the overuse of broad-spectrum antibiotics.
Furthermore, substandard sanitation and hygiene practices in certain areas create an environment where infectious diseases thrive, necessitating the frequent use of antimicrobial agents.

Education and awareness regarding the proper use of antibiotics are critical components in combating the menace. Unfortunately, there is a lack of comprehensive public awareness campaigns in Nigeria, leading to a low level of understanding among the population regarding the consequences of misuse. Healthcare professionals also need continuous education to promote judicious prescribing practices.

The multifaceted nature of the crisis demands a comprehensive response from individuals, healthcare workers, community and civil societies, businessmen, policymakers among others. Strengthening regulatory frameworks to control the sale of antibiotics, enhancing surveillance systems to monitor antibiotic use and resistance patterns, and investing in healthcare infrastructure are also essential.

WHAT HAPPENS IF WE DON’T ADDRESS ANTIMICROBIAL RESISTANCE?

Having explained the basis, importance and drivers of the antimicrobial resistance, it is now a high time to know the implication of failure to address the issue.

Increased mortality, prolonged illnesses, and a burden on healthcare systems are the most disastrous outcome. It’s not just a health crisis; but economic also, impacting productivity and increasing healthcare costs, if we ignore this crisis, it is like limited armory against infectious diseases, jeopardizing the progress we have made in medicine and healthcare in broader term. It is a strong reminder that the consequences of inaction are far greater than the challenges of taking action.

Therefore, as a medical student, several innovative solutions can be implemented to address the issue of antimicrobial resistance (AMR) and reduce its threat in the future.

INNOVATIVE WAYS TO ADDRESS THE ISSUE OF ANTIMICROBIAL RESISTANCE

The following are some of the ways based on my opinion that they can be used to reduce the threats of antimicrobial resistance:

CREATING ANTIMICROBIAL RESISTANCE AWARENESS CLUBS

Establishment of clubs in tertiary institutions, secondary schools and community youth clubs on antimicrobial resistance awareness is very important. Peers can work together and mobilize people, creating knowledge of antimicrobials use, misuse and the effect of the misuse.

THE USE OF MODERN MEANS OF COMMUNICATION

Social media is very powerful means of disseminating information to people. Social media platforms such as Facebook, WhatsApp, twitter has become active channels of news, communication and business advertisement in Nigeria and the world due to the vast number of users.

The access and use of mobile phones among the youth has made information dissemination so easy. Just on your bed you can wake up and surf for information, gist, see advertisements, entertainment with the mobile hand set.

Social media become so influential to the extent that, only one person can influence over millions of his followers hence, a very good tool for antimicrobial resistance awareness.

CREATE INTERVENTION PROGRAM FOR YOUTH UNDER ANTIMICROBIAL RESISTANCE CAMPAIGNS

Youth intervention program is a way to encourage and build a young person’s connection to his nation or community. Youth intervention providers work with the young people to help them engage and become contributing members of the society. Intervention programs are interventions designed to help individuals acquire skills, knowledge and gain financial freedom in order to be self-reliant and productive member of a society.

These include skill trainings such as mobile phones repairs, house wiring plumbing, carpentry, satellite installations and any other valuable skills. Healthcare authorities can partner with agencies providing those skills, so that they train the youth on various skill.

PROMOTING ANTIMICROBIAL STEWARDSHIP PROGRAMS

Implementing robust antimicrobial stewardship programs within medical and surgical settings is crucial. These programs involve a coordinated effort to optimize the use of antimicrobials, emphasizing proper prescription practices, dosage, and duration. Education of healthcare professionals on the principles of antimicrobial stewardship can contribute significantly to reducing unnecessary antibiotic use.

EDUCATION AND TRAINING PROGRAMS:

Integrating educational programs on AMR into medical and surgical curricula ensures that future healthcare professionals are well-equipped to handle the challenges posed by antimicrobial resistance. Continuous training programs can update practitioners on the latest developments in antimicrobial stewardship and responsible prescribing.

ENHANCING DIAGNOSTICS AND SURVEILLANCE

Investing in advanced diagnostic tools can help healthcare practitioners accurately identify pathogens and their susceptibility to antibiotics. Rapid diagnostic tests can guide clinicians in prescribing targeted therapies, minimizing the need for broad-spectrum antibiotics and reducing the selective pressure that drives AMR.
Establishing comprehensive surveillance systems can also aid in monitoring resistance patterns, enabling timely interventions.

INTEGRATING TECHNOLOGY IN HEALTHCARE

Leveraging technology, such as electronic health records (EHRs) and telemedicine, can enhance communication and information-sharing among healthcare professionals. This facilitates real-time data exchange on patient histories, antibiotic prescriptions, and resistance patterns, enabling more informed and coordinated decision-making.

MULTI SECTORAL COLLABORATION

Fostering collaboration among healthcare professionals, researchers, veterinarians, and policymakers is crucial. Interdisciplinary approaches can provide comprehensive insights into the complex dynamics of antimicrobial resistance, leading to more effective strategies. Collaborative efforts can bridge the gap between human and animal health, recognizing the interconnectedness of this issue across different sectors.

GLOBAL PARTNERSHIPS AND ADVOCACY

Engaging in international collaborations and advocacy efforts can amplify the impact of initiatives aimed at addressing antimicrobial resistance. Sharing best practices, research findings, and resources on a global scale can contribute to a unified response to this transboundary issue.

RESEARCH AND DEVELOPMENT OF NEW ANTIBIOTICS

Encouraging and supporting research and development initiatives for new antibiotics is essential. Incentivizing pharmaceutical companies to invest in the discovery of novel antimicrobial agents can replenish the dwindling antibiotic pipeline. This ensures that there are effective treatment options available to combat emerging resistant strains.
Therefore, embracing these innovative solutions, the field of medicine and surgery can play a pivotal role in mitigating the threat of antimicrobial resistance. These approaches not only enhance patient outcomes but also contribute to the global effort to preserve the efficacy of antimicrobial agents for generations to come.

Conclusively, antimicrobial resistance in Nigeria is a growing crisis with far-reaching implications for public health and beyond. Urgent and coordinated efforts are needed to address the root causes of this issue, including the inappropriate use of antibiotics, agricultural practices, healthcare infrastructure shortcomings, and inadequate public awareness.

Only through a holistic and collaborative approach can Nigeria hope to mitigate the impact of AMR and safeguard the effectiveness of antimicrobial drugs for future generations.
Bashir AbdulHayat

REFERENCES:
NIH– Strategies to combat antimicrobial resistance
Accessed on 20th November,2020 at https://www.ncbl.nih.gov/pmc/article/PMC4149102/
Meriam webster dictionary, android version
Jawetz M, et al; Textbook of Medical Microbiology 27th edition
WAAW2023 flyers; accessed on Facebook (m.facebook.com/page/waaw)