Antibiotic abuse in SA breeding 'superbugs'

24 January 2016 - 02:00 By CLAIRE KEETON

Superbugs that can cause life-threatening illnesses have spread beyond hospitals into the community in South Africa. The inappropriate use of antibiotics is fuelling their rise. "We have an increase in extremely drug-resistant bacteria ... which were not present 10 years ago," said Professor Adrian Brink, co-chairman of the South African Antibiotic Stewardship Programme. "People can be carrying superbugs in their tummies," he said.The map, left, shows confirmed cases of extensive- or totally-resistant bacteria.South African antibiotic use rose by roughly 80% per person compared with about 30% globally from 2000 to 2010, according to a recent report.This is largely due to a specific antibiotic used predominantly for preventing infections in HIV-positive patients.South Africans are among the biggest consumers of antibiotics worldwide and overuse is rife, but access is uneven between the private and public sectors.Roughly 80% of antibiotics are used by outpatients and about half of these will not benefit from them, Brink wrote this week in an article in Clinical Pulmonary Medicine."Inappropriate antimicrobial prescription is a significant problem," said Brink.Doctors should not prescribe antibiotics for the common cold, uncomplicated bronchitis, sinus infections or sore throats, the American College of Physicians said on Monday.One in five visits to emergency departments in the US were related to adverse reactions to antibiotics.There are two million antibiotic-resistant illnesses every year in the US, leading to at least 23000 deaths, the report said.Patients tend to focus on quick recovery: "GPs do overprescribe antibiotics for respiratory-tract infections, mainly because patients expect to leave with an antibiotic script. There is the false belief that antibiotics fix you fast; the pressure of life makes us all look for the quickest fix," said Dr Robbie Potenza, a Johannesburg GP.It helped to inform patients that antibiotics could breed resistance and "slow down recovery by interfering with their immune response to a virus", he said.   Viral respiratory-tract infections often go on to secondary bacterial infections needing antibiotics."What I do is attempt to educate during the consultation - as well as issuing an antibiotic script and instructing patients not to take the antibiotics unless the symptoms of a secondary bacterial infection appear," Potenza said.Antibiotics indiscriminately wipe out bacteria in the gut seen as crucial to health.Brink said the timing, dosage, duration and selection of antibiotics needed to be carefully considered.Rashes and diarrhoea are common side effects of antibiotics. There is a resistant strain of a diarrhoea-causing bacteria (Clostridium difficile) that can be fatal.Once-treatable infections are becoming difficult to cure as resistance to all first-choice and last-resort antibiotics is rising internationally, warns a 2015 report, The State of the World's Antibiotics by the Centre for Disease Dynamics, Economics and Policy."Instead of being the default treatment for a host of mild ailments ... antibiotics must be seen as life-saving medicines to be used when needed," the report said.In South Africa about a quarter of patients with the common infection E.coli will have a resistant strain that does not respond to fluoroquinolone , a survey from 2012 to 2014 found.South Africa has launched an antimicrobial-resistance national strategy framework . The Department of Health is forming a committee to drive the strategy, said spokesman Joe Maila.Provinces are evaluating their antibiotic usage and awareness campaigns have been conducted...

There’s never been a more important time to support independent media.

From World War 1 to present-day cosmopolitan South Africa and beyond, the Sunday Times has been a pillar in covering the stories that matter to you.

For just R80 you can become a premium member (digital access) and support a publication that has played an important political and social role in South Africa for over a century of Sundays. You can cancel anytime.

Already subscribed? Sign in below.



Questions or problems? Email helpdesk@timeslive.co.za or call 0860 52 52 00.