Introduction
Antibiotic resistance is a phenomenon that occurs when there is a bacterial change in response to the use of an antibacterial medicine. Bacteria become antibiotic-resistant. These bacteria may infect humans and animals, and the infections they cause are more challenging to treat. Intrinsically, this can be due to limited drug uptake by the bacteria, a bacterial mechanism to spit out the drug from its cells, inactivation of the drug by the bacteria, or by making amendments to the drug target. Self-medication is "the taking of drugs, herbs or home remedies on one's initiative, or on the advice of another person, without consulting a doctor." According to a study, self-medication is the most common reason for developing human pathogen resistance to antibiotic drugs. Self-medication promotes inappropriate drug use, incorrect dosage, and less adherence to medicine regimen plans that the healthcare workers have prescribed.
How do they relate?
Self-medication relies on amateur advice and experience. It has become a ground for antibiotic-resistant cases, where patients use their drug of choice based on their encounter with the disease in the past, mistrust of the healthcare system, and poor financial background are other factors that contribute to the cause. As per the study, patients self-medicate due to their customization to the treatment and to save time and expense.
Consequences of self-medication
Self-medication of antibiotics can contribute to the risk of skin issues, severe allergies, and hypersensitivity. The global problem of microbial resistance can be reduced by increasing non-medical populations' knowledge of allopathic treatments and their awareness of their use, particularly with antibiotics. Numerous people with problems involving antibiotic-resistant microbial infections are hospitalized each year in the United States. Of these, an estimated 23,000 patients pass away as a result of the lack of treatment options for such patients and the complex and fatal symptoms that these drug-resistant microorganisms cause and are challenging to diagnose. Approximately $20 billion annually is spent directly on treating antibiotic-resistant illnesses in the United States alone. According to a study, the global producer of forty percent of the world's antibiotics, i.e., India, had a case of over 58,000 infant deaths in 2013 attributed to antibiotic resistance.
Factors for self-medication
Several factors contribute to a patient's reliance on self-medication, mainly the person's previous experience with the disease and their thought process of treating it with the same approach as earlier. If a patient is living in poor economic conditions, this could also be another factor that causes patients to be unable to rely on the healthcare system. "Rx-to-OTC," which is when prescribed medicines are given as OTC after some time, is done based on the patient's experience and collected data. It aims to provide patients with convenience and independence for their treatment, but this encourages people to use drugs without the prescriber's supervision and can be a cause of microbial resistance among patients.
Issues for the future
Antibiotic resistance is on the rise and is a leading issue, making common diseases hard to treat, such as pneumonia, tuberculosis, blood poisoning, gonorrhea, and foodborne diseases. This can not only put an economic burden on the healthcare worker but can further harm a patient's life since this could push us into a post-antibiotic era, where even a tiny infectious injury could be fatal.
What can healthcare workers do?
Healthcare workers can work against the spread by decreasing the prescription of antibiotics and educating the patients to complete their course of medication while ensuring that the patients understand the risk of self-medication. Strict patient-dealing procedures should be followed by healthcare workers so that an individual does not become a target for nosocomial infection. This includes maintaining proper handwashing hygiene and using barrier equipment.
Strategies against antibiotic resistance
The U.S. national strategy for addressing antibiotic-resistant bacteria has several key objectives. Its primary goal is to reduce the rise of drug-resistant bacteria and prevent the spread of infections caused by these resistant strains. Additionally, it aims to expedite research and development in both fundamental and practical aspects for new antibiotics, alternative treatments, and vaccines. Another objective is enhancing the nation's One Health surveillance programs, encompassing various sectors to combat resistance effectively. Furthermore, the organization intends to establish partnerships with healthcare providers, patients, policymakers, and others to tackle the growing problem of antibiotic resistance, which is becoming increasingly widespread due to self-medication.
Sources
Reygaert, W. (2018). An overview of the antimicrobial resistance mechanisms of bacteria. AIMS Microbiology, 4(3), 482-501
Dentistry and self-medication: a current challenge. (2002, December 1). PubMed.
Rather, I. A., Kim, B., Bajpai, V. K., & Park, Y. (2017). Self-medication and antibiotic resistance: Crisis, current challenges, and prevention. Saudi Journal of Biological Sciences, 24(4), 808-812
Rathod, P., Sharma, S., Ukey, U., Sonpimpale, B., Ughade, S., Narlawar, U., Gaikwad, S., Nair, P., Masram, P., & Pandey, S. (2023). Prevalence, Pattern, and Reasons for Self-Medication: A Community-Based Cross-Sectional Study from Central India.
World Health Organization. (2020). Antibiotic resistance. https://www.who.int
Department of Health & Human Services. (n.d.). Antibiotic resistant bacteria. Better Health Channel.
How the U.S. collaborates to combat a global threat. (2021, April 1). Centers for Disease Control and Prevention.