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The middle east, like many other parts of the world, is becoming a hotbed of superbugs.
The warning was delivered by a study last summer and since then, the peril has been escalating.
The research, conducted by Hosam Mamoon Zowawi at the University of Queensland, Australia, says the reason for the spread of antibiotic-resistant bacteria is the over-use of antibiotics, poor hand hygiene in hospitals, and the large population of migrant workers who could have contributed to the spread of the bacteria.
The first systematic review of literature on antibiotic-resistant bacteria in the Gulf Cooperation Council (GCC) states — Saudi Arabia, the United Arab Emirates, Kuwait, Qatar, Oman and Bahrain — found a particular strain of potentially deadly superbugs, bacteria that are resistant to the carbapenem group of antibiotics and kill up to half of infected patients, has increased up to 90 per cent over the past two decades.
The World Health Organisation’s first global report on the phenomenon, Antimicrobial Resistance: Global Report on Surveillance, released on April 30 this year, says antibiotic resistance in bacteria “is happening right now in every region of the world, and has the potential to affect anyone, of any age, in any country”.
“Without urgent, coordinated action by many stakeholders, the world is heading for a post-antibiotic era in which common infections and minor injuries which have been treatable for decades can once again kill,” it adds.
Health experts in the UAE agree that we are overdoing antibiotics.
“By following the practice of popping pills today, we may be creating a drug-resistant monster for tomorrow,” says Dr Ashraf El Houfi, chairman of Dubai Hospital’s infection control committee.
Overuse of antibiotics in hospitals is also contributing to the birth of the superbug.
“Bacteria resistance is growing more than we are able to produce antibiotics,” Dr El Houfi says.
Misuse of antibiotics in the UAE is a cause for concern since one can walk over to a pharmacy counter and buy medicines without a doctor’s prescription.
The University of Queensland study identifies unique risk factors that could have contributed to the rise and spread of hospital- and community-acquired infections across GCC states, with the unnecessary use of antibiotics standing out as a particular risk.
Drugs are not candies Nivriti Butalia Antibiotics are easy to come by in Dubai, even those that are not supposed to be available over the counter. Khaleej Times visited a cross-section of drug stores to discover that not one pharmacist asked for a prescription before parting with medicines like Augmentin, Ciprobay and Amoxil. At a pharmacy at the exit of the Financial Centre Metro station, the pharmacist just wanted to know whether we wanted the drugs as pills or in liquid form. Ciprobay was out of stock, but the other two were readily available. At a well-known pharmacy at the Ibn Batuta Mall, the white coat-wearing head pharmacist, asked if they ever require a prescription, said customers are asked about the medicine they want to buy to make sure it is for the right reason. “Our job is to tell you, if you’re buying antibiotics for a sore throat, that you should instead buy lozenges and gargle... Antibiotics can harm your body. They’re not candies to be popped.” The head pharmacist said that in 2003-2004, when he was in Al Ain, the rule that a prescription was needed to buy medicines was followed more stringently. At another pharmacy in Dubai Marina, the pharmacist admitted that they don’t usually ask for a prescription. However she added that they keep records of the sale of stronger drugs, the ‘semi-controlled’ and ‘fully controlled’ ones. Stronger medicines will also not be sold without a doctor’s prescription. The pharmacist also said that once every couple of months, government inspectors come to inspect and take inventory of the sale of strong drugs. nivriti@khaleejtimes.com |
“Superbugs are born and grow from the irrational use of antibiotics and it’s clear from our research that active guidelines must be enforced to restrict their use in the GCC region,” Zowawi says in his study.
Although non-prescription sale of antibiotics is illegal in the GCC states, 68 per cent of pharmacies in Abu Dhabi, 78 per cent in Riyadh and 87 out of 88 pharmacies included in a study in Saudi Arabia sold them without a prescription.
Researchers also found that poor hand-hygiene compliance in hospitals and the region’s large population of migrant workers could have contributed to the spread of antibiotic-resistant bacteria.
“The emergence of superbugs can be explained as the survival of the fittest,” says Dr El Houfi. “Bacteria are smart, you see. Due to the overuse of antibiotics, they tend to mutate... following which the existing antibodies will no longer work.”
A variety of mutations are happening every second, he adds. “Antibiotics are becoming increasingly useless.”
asmaalizain@khaleejtimes.com
Time to act The solution is simple and the message clear. “Stop overusing antibiotics. This will decrease the mutations and the natural bacteria will do their work,” says Dr Ashraf El Houfi, chairman of Dubai Hospital’s infection control committee. He feels all prescriptions should be regulated. “A physician should stamp and sign his prescription. This will control the unnecessary use of antibiotics.” Interventions are needed to combat the medical disaster facing the GCC states. Hosam Mamoon Zowawi, the researcher at the University of Queensland, Australia, whose study says the Middle East is becoming a hotbed of superbugs, says health agencies across the Gulf states are taking serious action to stop the emergence and spread of antibiotic-resistant germs. “Improving basic infection control precautions like hand-hygiene, and prohibiting the availability of antibiotics without a prescription should also be mandatory, particularly in conjunction with a mass education campaign about antibiotic use,” his study recommends. Zowawi, who is vying for the Rolex Award for Enterprise, hopes his research will encourage more hospitals in the GCC to educate the public and implement a surveillance system to keep track of antibiotic-resistant microbes. The Dubai Hospital has already set up an antibiotic review committee that checks the dosage given to patients and monitors the prescriber. The pharmaceutical industry is racing against time to develop new drugs to fight the mutant microbes. “Developing medicines is a very expensive process and we are running out of formulas and drugs,” says Dr El Houfi. Dr Ziad Muhammad Al Saadi, a general practitioner from Medcare Hospital, Dubai says there are several reasons behind the misuse of antibiotics. “Some doctors are prescribing sooner than they are supposed to or the drug may not be correctly indicated,” he explains. “In some instances, patients are buying drugs over the counter or already have them at home.” Sometimes patients pressure doctors to prescribe certain medicines. “Patients do not have the required medical knowledge. In such cases, a doctor should explain clearly.” At times patients do not respond to emergency treatment because they were given a lot of antibiotics. “This is a long battle… as long as we live,” Dr El Houfi says. asmaalizain@khaleejtimes.com |
Tips for good health
>> Use antibiotics only when needed and as prescribed
>> Doctors should give the correct dosage
>> Do not use leftover medicines
>> The prescribed course should be completed by patients
>> Do not buy over the counter. A medicine that suits someone else may not be good for you
>> Use as indicated by physician
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