A different kind of ‘drug abuser’ and ‘pusher’ | Lifestyle.INQ

OCTOBER 27, 2022

You may not be taking “shabu,” cocaine or other substances, but you may unknowingly be a “drug user” or “drug pusher,” too.


Do you take antibiotics at the slightest sign of infection like a sore throat, flu-like symptoms, colds and cough?

If you do, then you’re a drug abuser, though of a different type. You may suffer equally serious complications in the future with your antibiotic abuse.


You’re unwittingly making yourself prone to more severe infections in the future, the bacteria in your body becoming resistant to common antibiotics.


A few weeks ago, we had to mildly reprimand a patient whom we’ve been following up in our clinic for a long-standing heart ailment. He said he was worried when he had fever, colds and cough four days earlier, so, without any doctor’s advice, he took a potent antibiotic to make sure the infection didn’t get worse.


When he came to us for follow up, he was already feeling better, and he thought he did the right thing by taking the antibiotic on the first day of symptoms.




But we had to explain to him that the majority of febrile infections are viral in nature and self-limiting, meaning, they get better after a few days, even without treatment. Supportive treatment, though, would help, including bed rest, hydration, lots of fruits and juices, symptomatic treatment such as taking antipyretic tablets for fever. But definitely  not antibiotics!


Health experts are now seriously alarmed about the looming emergence of a “superbug” due to antimicrobial or antibiotic resistance.


The World Health Organization (WHO) explains: “Antimicrobial resistance happens when microorganisms (such as bacteria, fungi, viruses and parasites) change when they are exposed to antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials and anthelmintics).


“Microorganisms that develop antimicrobial resistance are sometimes referred to as ‘superbugs.’ As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.”


Antibiotic resistance is one reason why, up to now, we have not successfully eradicated pulmonary tuberculosis (PTB) as other countries have. Local lung experts have constantly sounded the alarm of treatment-resistant PTB due to the inappropriate use of anti-TB drugs.


Cases of PTB should be treated with a minimum of a six-month course of anti-TB drugs. Some take it without a doctor’s prescription when they have long-standing cough, and stop it when their coughs are gone. They may not even have PTB to start with.


Some who really have PTB take it only for a few weeks or months, and when they get better, they stop taking their prescribed anti-TB regimen.


The result is treatment-resistant TB. The TB bacteria will come back with a vengeance and will be resistant to the commonly prescribed anti-TB drugs. More potent drugs will have to be given, which unfortunately have bothersome side-effects.


Resistant organisms


According to Dr. Malaya Santos, who writes a regular column in H&L (Health and Lifestyle) magazine, the extensive, improper use of antibiotics exposes bacteria to sub-lethal doses of the drugs and leads to the development of resistant organisms. “The implications are grim: when infections no longer respond to antimicrobial drugs, we may be left powerless as patients succumb to severe, life-threatening, incurable infections,” warns Dr. Santos.


This is the reason why a doctor’s prescription is required before we can buy drugs like antibiotics. But patients can apparently still buy a few pieces of antibiotics from some drugstores.


“In the developed world, the sale and dispensing of antibiotics, like other prescription drugs, is tightly regulated,” says Dr. Santos. “In many developing countries, despite the existence of laws to the contrary, it is still possible to purchase prescription medications without a prescription.”


Dr. Santos cites a 2016 review by Miller and Goodman published in the journal Health Policy and Planning (Oxford University Press), in which the authors analyzed data from 15 low- and middle-income Asian countries, including the Philippines. They confirmed that local pharmacy practice includes: 1) the sale of prescription drugs without a prescription; 2) clinically inappropriate drugs at incorrect doses; and, 3) incomplete courses of antibiotics.


The authors explain that in low- and middle-income countries in the region, pharmacies serve as the patients’ first point of contact with the healthcare system and their convenient source of advice on which medicines to purchase. Another author (Seeberg et al. 2014) says that the pharmacists actually serve as the “de facto primary healthcare providers” instead of the primary care physicians.


For sure, our pharmacists mean well, but they should realize they may be serving also as channels for antibiotic abuse and subsequent antimicrobial resistance. Figuratively, they’re serving as “drug pushers,” without meaning to be so.

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