After getting sick, most of us go to the nearest drugstore or search for some medicine at home. But, I never keep track of what medicine I am taking when I am sick. Most people think that antibiotics are needed. Apart from this, antifungal, antiviral, antiparasitic drugs are also available in the market. We may even use them all.

Before using such medicines, it is important to first know what caused the infection. For that, you should not use emergency medicine or go to a health professional for a test. Only after the results of blood, urine, sputum or any other sample, the disease can be diagnosed. Only then, on the recommendation of the concerned health worker, should one go for drug treatment.

Most of the time we get sick due to the infection of bacteria, viruses, fungi, parasites and other microorganisms. Antibiotics, antifungals, antivirals, antiparasitics are used to treat such microorganisms that infect us. Such drugs are collectively called antimicrobials. When these types of antimicrobials are overused, the microbes that infect the body are killed by the antimicrobial. Such a condition is called antimicrobial resistance (AMR). In simple terms, AMR is a situation where the drugs used do not work or when they do not work, high doses of drugs have to be used.

World Health Organization (WHO) former Director General Dr. Margaret Chan calls AMR a slow moving tsunami. WHO has considered AMR as a major threat, which will hinder the achievement of the Sustainable Development Goals. It is certain that it will affect health, economy, food security and development. 

According to a research article published in the Lancet journal in 2022, in 2019 alone, 1.27 million people worldwide died directly due to AMR. This number is one and a half times more than the number of deaths due to HIV AIDS in the same year. Children between the ages of one and five account for 20 percent of deaths due to AMR. According to the same research, 3,89,000 people died in the South Asia region alone, of which 84,000 were children under 5 years of age. The death rate of South Asia comes second after the continent of Africa. 

The impact of AMR is not limited to this. According to World Bank estimates, if AMR is not addressed in time, it will reduce global GDP by 3.8 percent by 2050. Because of this, 28 million more people will fall below the extreme poverty line. And global health spending will increase by $1 trillion per year. In a developing country like ours, where education is not accessible to the general public, businesses are not organized and the capacity of the regulatory bodies is not expected, this problem is sure to be more serious. It cannot be said that this problem does not lead to the loss of life even if there is a simple wound or injury.

AMR causes

Antibiotic resistance is a natural process and with the use of antimicrobials this resistance will eventually occur. Our responsibility is to prolong this transition as long as possible, so that the medicine can continue to work. However, we are now misusing these antimicrobials and even antibiotics. Even if we get a headache or a stomach ache or a common cold, we go to the nearest drug store and take antibiotics without checking. Even if we bring antibiotics home after checking

, if we feel like we are healthy in two-four days, we forget to take the medicine or keep it for the future. Because of our irresponsibility, germs are benefiting. He could change his genes to adapt to the changed environment and reapplying that antibiotic would have no effect. In that case, there may be a situation where the disease cannot be treated. Germs begin to resist themselves to antibiotics in both cases of more or less than the dose prescribed by the doctor. 

Antibiotics are used not only in humans but also in the growth and development of animals. Antibiotics used in animals and humans are often the same. In Nepal, there is a tendency to use antibiotics even before disease occurs in more commercially raised livestock. However, various studies have shown that antibiotics do not play a role in growth development. According to a study conducted by the Department of Animal Services across the country, an average of 254.95 milligrams of antimicrobials were used per kilogram of broiler chicken. This means that we are consuming 254.95 mg of antibiotics per 1 kg of chicken. In this way, antibiotics enter the body in an unknown way and make the germs in the body ineffective. 

Another factor in resistance is inattention to antibiotics in hospitals. Different types of patients are coming to the hospital. Some of them also have cases of AMR. Such as hospital carelessness: if there is a lack of hygiene, such resistant germs can reach people who do not have a problem. This condition is more likely to end up in the intensive care unit (ICU).

Also, even if doctors and drug dealers throw antibiotics directly into the garbage when disposing of them, the germs in the garbage can develop resistance to that antibiotic. Plants and animals that come in contact with that waste carry germs and enter our food cycle. If the germs that have developed AMR enter the food chain, it will be difficult for us to do anything to protect ourselves. AMR testing is relatively expensive in a resource-poor laboratory like ours. As a result, there is a delay in the identification and resolution of the problem.

What can we do? 

The government has prepared a national action plan to prevent the problem of resistance. Together, our small efforts to prevent or prevent the problem of antibiotic resistance can have a big impact. 

What we do is to prevent disease in the first place. For that, paying attention to personal and environmental hygiene, use of appropriate vaccines, exercise and rest can be done. If the disease persists, the medicine should be used only according to the instructions of the health worker and the dose should be completed in the prescribed time. In general, the drug store should not be forced to give antibiotics. Antibiotics are not necessary during viral infections and antivirals should be taken as directed by a physician if needed, emphasizing rest during that time. Similarly, even in domestic or commercially raised animals, the problem will be reduced unless antibiotics are used only when they get sick and unauthorized misuse of antibiotics is avoided.