In 2013, Montenegro ranked second in Europe in consumption of antibiotics, which are often used unnecessarily in treatment.
Referring to European research from 2013, pediatrician Nina Pejović-Mandić, PhD, member of the National Interdisciplinary Commission for the Control of Bacterial Resistance to Antibiotics (NIKRA) at the Ministry of Health, told "Vijesti"
She assessed that resistance to antibiotics is a complex problem, which occurs mainly due to excessive and frequent use in situations where it is not necessary to administer them.
She explained that infections are caused by bacteria and viruses, which is why the method of treatment is completely different, although the disease sometimes manifests itself with seemingly similar symptoms.
She pointed out that antibiotics kill bacteria by destroying their protective wall and reproduction, while they have no effect on viruses.
According to her, among the most common bacterial infections that are treated with antibiotics are infections of the ear, lungs, kidneys and urinary system.
"Giving antibiotics at the beginning of the disease will not prevent the development of complications, but only complicate and prolong the treatment," warned the doctor.
When asked how a doctor can assess whether a patient has a viral or bacterial infection, she answered that the diagnosis of a viral infection is usually based on a clinical examination, and that, if there are doubts, they ask for laboratory findings and smears.
In pediatrics, he claims, they do not give any medicine lightly, especially antibiotics, thus investing in the child's health in the long term.
The doctor pointed out that the most common reason for visiting a pediatrician is an acute infection of the upper respiratory tract, which in 95 percent of cases is viral.
She said that in kindergartens it is common for children to have complaints such as cough, sometimes accompanied by a slightly elevated temperature.
He claims that we can speed up the development of resistant bacteria if we give antibiotics to children under the age of three in such situations.
"Also, there are 'good bacteria' on the surfaces of the oral cavity, nose, and intestinal mucosa, which protect the body from infection. Antibiotics defeat them, so a lot of antibiotics means more frequent viral infections," she explained.
She said that it is often difficult for pediatricians in these situations to explain to parents that they are doing the child a great favor if they leave the clinic "empty-handed" without a prescription for antibiotics.
She claims that any medicine, even when given justifiably, can show "bad sides".
"In the case of antibiotics, these are allergies, problems with the digestive organs, in the sense of interfering with the work of bacteria that are normal inhabitants of the intestines...", she pointed out.
The state has been working for four years to ensure that antibiotics are used rationally
Pejović-Mandić said that NIKRA has existed within the Ministry of Health for four years and gathers around twenty members (specialists in various fields of medicine, lawyers, pharmacists, veterinarians...).
She explained that NIKRA created the National Strategy for the Control of Bacterial Resistance to Antibiotics, launched a series of activities to educate health workers and the general population about the importance of rational use of antibiotics, as well as initiated the writing of a guide.
He claims that monitoring of resistance to carbapenems (currently the most powerful antibiotics) in hospitals has been introduced. The doctor said that increased supervision over the dispensing of antibiotics in pharmacies has been implemented, so that they are now only available with a doctor's prescription.
The problem of "parental pressure" is solved by education
The doctor emphasized that there is so-called "parental pressure" when they insist on antibiotics, but also that doctors, who receive dozens of patients a day, do not have the conditions to present the story of antibiotic resistance to everyone, even though the advice is "key therapy" for acute viral infections.
She assessed that it is important for doctors in health centers to educate parents and explain that the preventive use of antibiotics has no effect on the possibility of developing other bacterial infections, that they potentially have serious side effects, and that irrational use contributes to resistance.
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