Antibiotics: Misuse puts you and others at risk

Antibiotics can be lifesavers, but misuse has increased the number of drug-resistant germs. See how this affects you and what you can do to help prevent antibiotic resistance.

If you think antibiotic resistance isn't a problem or doesn't affect you, think again. A prominent example of the dangers of antibiotic resistance is the spread of MRSA — or methicillin-resistant Staphylococcus aureus. MRSA was once a concern only for people in the hospital, but a newer form of MRSA is causing infections in healthy people in the community.

Antibiotic resistance occurs when antibiotics no longer work against disease-causing bacteria. These infections are difficult to treat and can mean longer lasting illnesses, more doctor visits or extended hospital stays, and the need for more expensive and toxic medications. Some resistant infections can even cause death.

Although experts are working to develop new antibiotics and other treatments to keep pace with antibiotic-resistant strains of bacteria, infectious organisms adapt quickly. Antibiotic-resistant bacteria will continue to be a global health concern — and using antibiotics wisely is important for preventing their spread.

When is it appropriate to use antibiotics?

Antibiotics are effective against bacterial infections, certain fungal infections and some kinds of parasites. Antibiotics don't work against viruses. The chart shows common illnesses and whether they're caused by bacteria or viruses. Taking an antibiotic when you have a viral infection won't make you feel better — and can contribute to antibiotic resistance.

Bacterial infections	Viral infections
·         Some ear infections ·         Severe sinus infections ·         Strep throat ·         Urinary tract infections ·         Many wound and skin infections	·         Most ear infections ·         Colds ·         Influenza (flu) ·         Most coughs ·         Most sore throats ·         Bronchitis ·         Stomach flu (viral gastroenteritis)

Consequences of antibiotic misuse

If antibiotics are used too often for things they can't treat — like colds, flu or other viral infections — they become less effective against the bacteria they're intended to treat. Not taking antibiotics exactly as prescribed also leads to problems. For example, if you take an antibiotic for only a few days — instead of the full course — the antibiotic may wipe out some but not all of the bacteria. The surviving bacteria become more resistant and can be spread to other people. When bacteria become resistant to first line treatments, the risk of complications and death is increased. In the United States alone, thousands of people die each year of antibiotic-resistant infections they contracted in the hospital.

The failure of first line antibiotics also means that doctors have to resort to less conventional medications, many of which are more costly and associated with more serious side effects. For instance, the drugs needed to treat drug-resistant forms of tuberculosis (TB) are much more expensive than are the drugs used to treat nonresistant TB. The course of treatment is long — up to two years — and the side effects can be severe.

Other consequences are the increased costs associated with prolonged illnesses, including expenses for additional tests, treatments and hospitalization, and indirect costs such as lost income

Antibiotics: Misuse puts you and others at risk

Antibiotics can be lifesavers, but misuse has increased the number of drug-resistant germs. See how this affects you and what you can do to help prevent antibiotic resistance.

If you think antibiotic resistance isn't a problem or doesn't affect you, think again. A prominent example of the dangers of antibiotic resistance is the spread of MRSA — or methicillin-resistant Staphylococcus aureus. MRSA was once a concern only for people in the hospital, but a newer form of MRSA is causing infections in healthy people in the community.

Antibiotic resistance occurs when antibiotics no longer work against disease-causing bacteria. These infections are difficult to treat and can mean longer lasting illnesses, more doctor visits or extended hospital stays, and the need for more expensive and toxic medications. Some resistant infections can even cause death.

Although experts are working to develop new antibiotics and other treatments to keep pace with antibiotic-resistant strains of bacteria, infectious organisms adapt quickly. Antibiotic-resistant bacteria will continue to be a global health concern — and using antibiotics wisely is important for preventing their spread.

When is it appropriate to use antibiotics?

Antibiotics are effective against bacterial infections, certain fungal infections and some kinds of parasites. Antibiotics don't work against viruses. The chart shows common illnesses and whether they're caused by bacteria or viruses. Taking an antibiotic when you have a viral infection won't make you feel better — and can contribute to antibiotic resistance.

Bacterial infections	Viral infections
·         Some ear infections ·         Severe sinus infections ·         Strep throat ·         Urinary tract infections ·         Many wound and skin infections	·         Most ear infections ·         Colds ·         Influenza (flu) ·         Most coughs ·         Most sore throats ·         Bronchitis ·         Stomach flu (viral gastroenteritis)

Consequences of antibiotic misuse

If antibiotics are used too often for things they can't treat — like colds, flu or other viral infections — they become less effective against the bacteria they're intended to treat. Not taking antibiotics exactly as prescribed also leads to problems. For example, if you take an antibiotic for only a few days — instead of the full course — the antibiotic may wipe out some but not all of the bacteria. The surviving bacteria become more resistant and can be spread to other people. When bacteria become resistant to first line treatments, the risk of complications and death is increased. In the United States alone, thousands of people die each year of antibiotic-resistant infections they contracted in the hospital.

The failure of first line antibiotics also means that doctors have to resort to less conventional medications, many of which are more costly and associated with more serious side effects. For instance, the drugs needed to treat drug-resistant forms of tuberculosis (TB) are much more expensive than are the drugs used to treat nonresistant TB. The course of treatment is long — up to two years — and the side effects can be severe.

Other consequences are the increased costs associated with prolonged illnesses, including expenses for additional tests, treatments and hospitalization, and indirect costs such as lost income

What you can do to safeguard antibiotic effectiveness

Repeated and improper use of antibiotics is the primary cause of the increase in the number of drug-resistant bacteria. Here's what you can do to promote proper use of antibiotics:

·         Understand when antibiotics should be used. Don't expect to take antibiotics every time you're sick. Antibiotics are effective in treating most bacterial infections, but they're not useful against viral infections, such as colds, acute bronchitis or the flu. And even some common bacterial ailments, such as mild ear infections, don't benefit much from antibiotics.

·         Don't pressure your doctor for antibiotics if you have a viral illness. Instead, talk with your doctor about ways to relieve your symptoms — for instance, a saline nasal spray to clear a stuffy nose or a mixture of warm water, lemon and honey to temporarily soothe a sore throat.

·         Take antibiotics exactly as prescribed. Follow your doctor's instructions when taking medication. Don't stop treatment a few days early because you're feeling better. Taking the full course of antibiotics is the only way to kill all of the harmful bacteria. A shortened course of antibiotics, on the other hand, often wipes out only the most vulnerable bacteria while allowing relatively resistant bacteria to survive.

·         Never take antibiotics without a prescription. If you didn't complete a full course of antibiotics, you might be tempted to use the leftover medication the next time you get sick or to pass it along to someone else. But this isn't a good idea. For one thing, the antibiotic might not be appropriate for a future illness. And even if it is, you're not likely to have enough pills to combat the germs making you sick, which can lead to more resistant bacteria.

·         Prevent the spread of germs. Good hygiene goes a long way in preventing infection. Wash your hands thoroughly with soap and water, especially after using the toilet, changing a diaper, or handling raw meat or poultry. Keep food preparation areas clean. Although antibacterial cleaners and soap are widely available, they aren't necessary. Plain soap and water work fine to kill germs in most settings.

Protect yourself and others

Antibiotic resistance is a global health problem. Nearly all significant bacterial infections in the world are becoming resistant to commonly used antibiotics. When you misuse antibiotics, you help create resistant microorganisms that can cause new and hard-to-treat infections. That's why the decisions you make about using antibiotics — unlike almost any other medicine you take — have far-reaching consequences. Be responsible in how you use antibiotics to protect your health and that of your family, neighbors and community.

Fake drugs flood Bangladesh

New investigations reveal an estimated US $150 million worth of spurious drugs are posing a risk to public health at Bangladesh. In its annual testing of 5000 drug samples this year, the Public Health and Drug Testing Laboratory (PHDTL) detected 300 drugs that are either counterfeit or of very poor quality. Significantly, these include many popular antibiotics and lifesaving drugs. Jolted into action, the health ministry's Drug Administration authorities have launched a drive against illegal and fake drug vendors in the country. Preliminary findings reveal Bangladesh boasts a whopping 80,000 unlicensed drugstores. Drug administration officials express their helplessness in combating the menace,"There are so many illegal operators that we cannot cope. Our 25 branches across the country are staffed with just 40 drug superintendents and inspectors. We act when we get specific complaints. But this set up is hopelessly inadequate." They point out that smuggled drugs are the biggest threat, as this is a grey area which is totally unmonitored. In the absence of quality controls, any dishonest importer can smuggle in fake drugs at a takeaway price and sell them at a higher price, experts remark. The rampant growth of contraband drugs is blamed on the poor quality of health services and cutthroat competition between drug manufacturers. The 100,000 strong industry produces drugs worth over US $500 million. Worse, the acute shortage of doctors and clinics in rural areas forces patients to purchase off-the-counter drugs sans a prescription. This helps fake drug vendors to thrive, stresses a pharmaceutical industry executive. A large percentage of patients also travel to neighboring India for treatment, returning with prescriptions of Indian drugs. To cater to them, dozens of unauthorized pharmaceutical establishments have mushroomed on the Bangladesh border. These units either smuggle in Indian drugs or manufacture fake ones that threaten the lives of thousands of patients, experts observe. Although doctors warn these drugs could be causing deaths, no survey has so far been conducted to assess their negative impact on public health. Recently, the Drug Testing Laboratory found that a popular drug used for strokes and brain hemorrhages - Cavinton - was being marketed minus its main chemical ingredients. "It is obvious that patients who used this counterfeit drug have either died or suffered an ordeal," they say. Ironically as the Bangladesh Pharmaceutical Industries Association remarks, "The presence of fake and illegal drugs in Bangladesh is itself surprising because we manufacture over 96 per cent of our requirements and even export drugs." The value of fake and contraband drugs flooding the market is estimated to be between US $100 million and $150 million. According to him, these drugs are produced in hundreds of fly-by-night drug factories functioning along the borders of Bangladesh, India, Pakistan, China and Thailand. Paradoxically though, the Chemist and Druggist Association points out, the pharmaceutical industry is Bangladesh's second largest foreign exchange earner, boasting exports to 52 countries. The industry comprises over 800 drug-manufacturing companies, 230 of which manufacture allopathic drugs, 255 producing traditional herbal drugs, 300 engaged in the manufacture of modern herbal drugs and 80 homeopathic drug producing outlets. It alleges that apart from some three dozen leading allopathic drug manufacturers, the rest are involved in the production of fake and low quality drugs. The forum terms this cannibalistic marketing of competing companies. "Due to its high returns, businessmen with no commitment to health services have started investing in the pharmaceutical sector. Their companies thrive on faking popular brands and manufacturing drugs sans authentic ingredients. The low prices help their drugs to sell," it says. Many companies manufacture fake post-operative antibiotics like cephradine and hydrocortisone. Fungus-coated saline fluids and used syringes are also commonly found. In addition, most drug manufacturers lack suitable storage facilities and enclose tablets and capsules in such low quality foil that it is impossible for them to retain their potency. Health ministry says the local pharmaceutical industry meets nearly 96 percent of the country's drug demands. According to the ministry, it has ordered a crackdown on illegal drug networks in the country. "We are preparing to sue some 15 illegal and fake drug vendors in the capital Dhaka. We are currently inspecting other towns and cities as well."

Suffer for people in climate change in Bangladesh

Bangladesh's Hungry Feel Heat Of Climate Change

BangladeshA History of Bangladesh: Politics, Economic and Civil Society is a very flat, low-lying country, lying largely on a river delta fed by three great rivers, the Ganges, Brahmaputra and Meghna. In all, there are 230 rivers, large and small, criss-crossing the country. With an area of 147,570 km2
 

This population density, as well as Bangladesh’s poverty, and its unique vulnerability to climate related disasters, such as floods, sea-level rise droughts and cyclones, all mean that Bangladesh will be hit hard by the effects of climate change. What’s worse, of course, is that although Bangladesh will suffer earliest and most from climate change, it has had little to do with causing the problem.

Water could be the most crucial of climate change issues facing Bangladesh over the coming decades. Bangladesh looks set to be swamped on all sides, with the Inter-government Panel on Climate Change (IPCC) predicting increased flooding throughout the country due to glacier melt and more intense monsoons, as well as increased swamping of southern and western coastal areas due to sea level rises (IPCC 2007:10). Added to this, many parts of the country are predicted to experience further hardship through increased likelihood of drought (IPCC 2007:11) outside of the monsoon season.

These changes are already being felt by the rural poor

The Sundarbans nature reserve in Bangladesh's south-west is one of the last untouched places on Earth - and home to the largest population of tigers left in the wild. But the trees in the Sundarbans have suddenly started dying. And not just that: they have started dying in a way nobody has seen before, from the top down.

Nobody is sure what the cause is, but the country's leading scientists think the trees are dying because, in recent years, the water has turned from fresh to salty. The Sundarbans is a massive mangrove swamp, and the sea has begun encroaching. What we are seeing may be one of the first casualties of rising sea levels caused by global warming. "Nobody can say for sure whether it is climate change because there haven't been proper in-depth studies," says Professor Ainun Nishat, one of the country's leading environmentalists, and one of those involved in the UN's recent climate change report. "But this is the sort of effect rising sea levels will have on Bangladesh. We are fighting climate change on the front line. But the battle has to be integrated across all countries."