Medication resistance, also known as antimicrobial resistance (AMR), is a significant and growing problem that poses grave implications for patients and healthcare systems worldwide.
It refers to the ability of microorganisms, such as bacteria, viruses, parasites, or fungi, to withstand the effects of medications that were once effective in treating infections and diseases caused by these pathogens.
The rise of medication resistance is fuelled by several factors, including overuse and misuse of antibiotics and other antimicrobial drugs, inadequate infection prevention and control practices, and the natural ability of microorganisms to evolve and adapt.
The implications of medication resistance are far-reaching and multifaceted.
Firstly, it directly affects patient health outcomes. When medications become ineffective against infections, patients may experience prolonged illness, increased morbidity, and even death.
Treatments that were once considered routine, such as common surgeries or chemotherapy, could become high-risk procedures if the risk of infection cannot be adequately managed due to medication resistance. This can lead to increased healthcare costs, longer hospital stays, and reduced quality of life for patients.
Medication resistance also poses a significant challenge to healthcare systems.
The need for alternative, more potent, and often more expensive drugs to combat resistant infections places a substantial economic burden on healthcare budgets.
The development of new medications is a lengthy and costly process, and there are limited options available to replace those that have lost their efficacy.
Additionally, the management of medication-resistant infections requires specialised laboratory testing, infection control measures, and healthcare personnel trained in dealing with such cases, which further strains healthcare resources
Causes
Antibiotics are powerful medications used to treat bacterial infections.
However, the overuse and misuse of antibiotics have contributed significantly to the emergence of antibiotic-resistant bacteria.
Factors that contribute to antibiotic overuse include prescribing antibiotics for viral infections, inappropriate self-medication, unnecessary or prolonged use of antibiotics, and agricultural use of antibiotics in livestock.
Overuse exposes bacteria to antibiotics for extended periods, increasing the likelihood of the survival and proliferation of resistant strains.
Misuse of medications, including incorrect dosages, incomplete treatment courses, and using medications without proper medical guidance, can also contribute to medication resistance.
When medications are not used as prescribed, the optimal concentration of the drug in the body may not be achieved, allowing some microorganisms to survive and develop resistance.
Inadequate infection control practices in healthcare settings can facilitate the spread of drug-resistant microorganisms.
These include poor hand hygiene, improper sterilisation and disinfection techniques, inadequate isolation of infected patients, and overcrowding in healthcare facilities.
When drug-resistant microorganisms are allowed to spread, they can infect vulnerable individuals and contribute to the overall burden of medication resistance.
Lack of new drug development: The dwindling pipeline of new antimicrobial drugs is a concerning factor in the battle against medication resistance.
Pharmaceutical companies face several challenges in developing new drugs, including high research and development costs, regulatory hurdles, and the potential for limited profitability.
This limited availability of new drugs restricts treatment options and puts greater reliance on existing medications, increasing the risk of resistance.
The consequences of drug resistance
The consequences of over use of meds include medical costs. Medication resistance can result in increased healthcare costs. When a patient becomes resistant to medication, alternative treatments may be required. These alternatives might involve more expensive medications or additional interventions such as surgeries, therapies, or diagnostic tests.
Additionally, the need for ongoing monitoring and adjustments to the treatment plan can contribute to increased healthcare expenses.
Medication resistance can lead to a decrease in the effectiveness of treatments. Initially, a medication may effectively manage a patient's condition or symptoms. However, over time, the body can develop mechanisms that make the medication less effective. This reduced efficacy can result in inadequate control of the disease or condition, leading to persistent symptoms, disease progression, or complications.
Medication resistance can pose risks to patients' health and well-being.
When a medication loses its effectiveness, patients may experience a worsening of their symptoms or a relapse of their condition.
This can result in decreased quality of life, functional impairment, and increased morbidity.
In some cases, patients may need to switch to more potent or riskier medications with potential side effects or adverse reactions, which can further increase the risks associated with treatment.
Medication resistance may prolong the duration of an illness or condition.
When a patient becomes resistant to a medication, it can be challenging to find an alternative treatment that effectively manages the condition.
This delay in finding an appropriate treatment can lead to prolonged illness, increased suffering, and a longer recovery period.
Addressing medication resistance requires a multifaceted approach involving various stakeholders, including healthcare providers, researchers, policymakers, and patients themselves.
Improving patient education and awareness can play a crucial role in addressing medication resistance.
Patients should be educated about the importance of medication adherence, the risks associated with non-adherence, and the potential development of resistance.
Clear communication
About treatment goals, expected outcomes, and possible side effects can empower patients to make informed decisions and actively participate in their treatment plans.
Promoting the appropriate use of medications is essential to minimise the development of resistance.
Healthcare providers should follow evidence-based guidelines and prescribe medications judiciously, considering factors such as the patient's medical history, drug interactions, and the potential for resistance.
Implementing antimicrobial stewardship programmes can help reduce the overuse and misuse of antibiotics, which is a significant contributor to antibiotic resistance.
Emphasising personalised medicine approaches can help optimise treatment effectiveness and reduce the risk of resistance.
By considering individual patient characteristics, such as genetic factors, underlying conditions, and biomarkers, healthcare providers can tailor treatment plans to maximise efficacy.
This may involve selecting the most appropriate medication, adjusting dosages, or combining therapies to target multiple pathways or mechanisms.
Establishing robust surveillance systems to monitor medication resistance patterns is essential for timely intervention and management.
Collecting data on resistance rates, treatment outcomes, and emerging resistance mechanisms can inform treatment guidelines, identify high-risk populations, and guide research efforts.
Continuous monitoring allows for early detection of resistance and facilitates the implementation of targeted interventions.
*Gary Gerald Mtombeni is a journalist based in Harare. He writes here in his own personal capacity. For feedback Email garymtombeni@gmail.com/ call- +263778861608