By Candy Ho
Feeling better already before completing your prescribed dosage of antibiotics and thinking there's no need to continue taking the pills? Experiencing symptoms of the common cold and thinking of taking antibiotics? Proper use of antibiotics like finishing the entire course when prescribed or not taking antibiotics for the common cold due to viruses will help combat antimicrobial resistance, now emerging as a global problem.
The rapid spread of antimicrobial resistance might one day lead to drug ineffectiveness against even the most common infections.
The World Health Organization (WHO) has called on governments, healthcare professionals and patients to collectively take corrective action against rising drug resistance.
Tan Tock Seng Hospital (TTSH) has heeded WHO's call with its Antimicrobial Stewardship Programme (ASP), implemented in 2009 following two years of intensive data collection. TTSH's ASP utilises a multi-pronged approach to ensure proper use of antibiotics. Comprehensive guidelines on antibiotic prescription were developed and integrated into a computer programme with information on patients' medical history. In addition trained infectious disease and ward pharmacists work tirelessly, in consultation with infectious disease physicians, to encourage the appropriate use of antibiotics in TTSH. This was spearheaded by assistant professor Christine Teng, a pharmacist and key member of the ASP team.
The idea of the ASP is to make scientifically-proven guidelines on antibiotic usage widely available in the hospital, and to provide feedback on antibiotic use and resistance to doctors regularly. It has helped doctors prescribe the right dosage of medication to the right patient at the right time.
With the programme, TTSH has reduced the occurrence of superbugs by 36 percent. This comes as the hospital decreased its antibiotic usage by 15 percent. Most importantly, this has been achieved without any increase in hospital deaths or compromises in patient safety.
Antimicrobial resistance develops when micro-organisms change in ways to render medication ineffective. This can happen when antibiotics kill susceptible bacteria, but leaves a sub-population of antimicrobial-resistant bacteria, which can then become the dominant strain, explained Dr David Lye, an infectious disease consultant and head of TTSH's ASP.
"Such antibiotic-resistant bacteria can spread through the environment and via hand contact," said Dr Lye. Inappropriate and unnecessary use of antibiotics also hastens this process.
Inventing new replacement drugs is one way to beat antimicrobial resistance, but new drugs take time to develop. Having strong antimicrobial programmes in place at hospitals is thus critical in turning the tide against drug resistance. Patients can also play a part by not requesting for antibiotics for common infections, such as the cough and cold, which are usually caused by viruses. Antibiotics for diarrhoea have also not been shown to be effective, said Dr Lye.
Patients can help to prevent the spread of drug resistance by complying with the prescribed dosage of drugs by their doctors and completing it fully, he added.
So the next time you feel like you've almost recovered before finishing your course of antibiotics, don't chuck those pills. Taking them all helps you guard against drug resistance.
The article is written based on an interview with Dr David Lye, consultant at the Infectious Diseases Department at Tan Tock Seng Hospital.