Are ‘super bugs’ a threat to my child?

Are ‘super bugs’ a threat to my child?

Dr Ombeva,

I am a mother of a three-year-old child. I read a worrying article recently, where the World Health Organization reported that there were ‘super bugs’ out there - like the strain of the sexually transmitted disease called gonorrhea - that are resistant to all the common antibiotics used to treat the diseases.

That left me wondering what disease will be next and just how this resistance to antibiotics develops. Is there something we can do as parents when administering medication to our children? What needs to be done to stop resistance?  If nothing is done, we may reach a point where we are not able to treat most diseases.

[Claudette]

Dear Claudette,

Resistance develops when bacteria are exposed to an antibiotic and incomplete killing occurs, leaving some bacteria that then evades the antibiotics and become resistant. This can follow overuse of antibiotics, or inappropriate use of antibiotics, or poor infection control measures or a lack of surveillance and adequate antibiotic stewardship/policing.

The more the antibiotics a person uses, the higher the chance the person has of acquiring bacterial resistance. In Africa, most antibiotic prescription is largely empirical, and some may be at lower doses, not adequate to clear the bacteria, especially as most prescribers try to avoid the newer more expensive drugs.

Research suggests that more than 50 per cent of antibiotics prescribed are unnecessary; in fact, I think the figure is about 70-80 per cent. We, therefore, end up with current and new patients with diseases that we can’t treat, or that we need newer and more expensive drugs to treat.

These forms of diseases are more aggressive, their patients end up with more complications and a higher likelihood of death, prolonged hospitalization, intensive care admission or long-term complications as a consequence. We need to preserve the effectiveness of currently available antibiotics other than relying on new drugs.

All hospitals should institute antibiotic stewardship programmes that monitor and guide the use of antibiotics and infection control programmes, which is a form of antibiotic policing. Stewardship programmes encourage prescribers to only give an antibiotic when it is needed – and not to give antibiotics say for flu or viral infections.

Emphasis should be put on infection control measures like washing hands and isolating patients infected with resistant organisms. Doctors need to wash hands more. They may use either alcohol-based solutions or soap and water for hand hygiene. At a more national level, there is need for infection control and antimicrobial stewardship guidelines that strengthen the surveillance systems and general antibiotic use and distribution.

— Dr Ombeva Malande is a pediatrics and child health expert