THE GROWING MENACE OF ANTIBIOTICS MISUSE IN PAKISTAN

'Use and abuse of antibiotics has longbeen recognised as a challenge confronting many developed and developing nations. While the more vigilantnations have been able toaddresstheissuethroughstrict drug controlregulations,countrieslikePakistan continuetostruggle with themenace ofimproper useofmedicines speciallytheantiinfective agents.Impact of thishazardous trendonthehealthand economyofoursocietytends togo un-noticedandthepublic, health officials aswellas media officials seem tobeeitherleastinterested orcompletely unaware of the implications involved.Antibioticsareessentialdrugswhich appear tochange, forbetter orworse,thenatureofseveraldisorders,including bowelconditions,metabolicdisordersorliver disease1.Theyare known toreduce morbidityfrom a varietyofbacterial infectionsandarepotentiallifesaversin certain floridseptic conditions suchas bacteremia and meningitis.Their inappropriate use, however has ledtodecreased efficacyandbacterialresistance, therebyundermining theirusefulpotential. Thelater effect i.e. resistance ofcertain bacterium to respondto drugs theyare usuallysusceptible to, results froma genemutationthateither protects it from the actionof the drug orneutralizesit2.Globally therehasbeen a surge ofresistant pathogensincluding methicillin resistantstaphylococcus aureus, penicillin resistantstreptococcus pneumonia andvancomycin resistantenterococci.Anymicro-organism thatsurvives anantibiotic treatmentcan multiplyand pass on its resistantproperties. Afactor responsible for this unfortunatescenarioincludes;Over-prescribing and under prescribing antibiotics by the caringphysician.Exaggerationofsymptomsbypatients togeta prescriptionofantibiotics not actually needed3Reluctance onpartof the patients to followcomplete course ofantibioticsas theyfeel better4wrongchoice of antibioticsUsingantibioticsforconditions where theyarenot indicated such asviral infections (common cold andflu like symptoms)IntheUnitedStates,according toa2013report bytheCentresforDisease Controland Prevention,atleast 2 millionpeople annually"acquireseriousinfections with bacteria thatare resistant to one ormore oftheantibiotics designedto treatthose infections."Itis estimatedthatatleast 23,000people die annuallyfromantibiotic-resistantinfections.Comparative morbidityand mortalityis muchhigherin underdevelopedand developingnations of the world.Thespectrum of resistance differsacross developed and developing countries specificto theirown circumstances5. Pneumococcalresistance towards