A simple infection can be fatal

The American Food and Drug Administration (FDA) has issued a warning that the popular antibiotic azithromycin, which is also registered in Montenegro, can cause potentially fatal heart rhythm disorders in some patients.

This is an additional blow to the already shaken confidence in the effect of drugs belonging to that group, since the main preoccupation of the health authorities in the world for years is precisely the growing resistance to antibiotics with the ever-present new "super bacteria".

What worries scientists is the fact that no new antibiotic has been discovered for 25 years, while new diseases and "super bacteria" are constantly "multiplying".

Recently, the British "Guardian" published a detailed analysis of the increasingly common occurrence of inadequate effects of these drugs in the fight against new infections.

According to the newspaper, antibiotics were a miracle of the twentieth century - ever since Alexander Fleming discovered penicillin, we have been in the habit of using them every time we get a cold. But that habit will backfire on us.

The World Health Organization (WHO) estimates that antibiotic-resistant infections cost the European Union €1,5 billion a year, while the United States spends $30 billion a year.

The study states that 85 percent of families in Russia "routinely" use antibiotics, while strains of bacteria resistant to that group of drugs have been found even in Antarctica.

The head of the health sector in Great Britain, Dame Davies, said that unless some global action is taken, health systems around the world will return to the beginning of the nineteenth century.

"Antimicrobial resistance is a catastrophic threat," Davis said. "If we don't act now, any of us could go to hospital in 20 years for a minor operation and die from a simple infection that can be treated with antibiotics. Thus, routine interventions, such as hip implantation or organ transplantation, can be fatal due to the risk of infection. That's why I call on governments and organizations around the world, including the WHO and the G8, to take this seriously."

The growth of "super bacteria", for which only a few antibiotics can be used, certainly does not contribute to the fight. The problem is that antibiotics are used uncontrollably, and patients regularly do not follow the doctor's recommendations on their use, which leads to the emergence of resistance. A problem that is given less importance is the appearance of bacteria in soil and animal feed, since they are introduced into the human body through food.

According to the findings of the European Center for Disease Control, Greece has the highest consumption of antibiotics in Europe, with an average of 1.000 doses of antibiotics per 34,9 inhabitants per day, followed by Cyprus, Luxembourg and Belgium.

The problem did not bypass Montenegro either: data from Montenegro show that in 2011, as many as 485.000 prescriptions for antibiotics with a total value of 1,7 million euros were issued. This accounts for more than 10 percent of the total consumption of prescription drugs.

Montenegro is one of the European countries with a high consumption of antibiotics, and as expected also among the countries with high rates of resistance to that group of drugs.

However, in Montenegro, there is no established system for monitoring resistance, the authorities in the Ministry of Health admit in the National Strategy for the Control of Bacterial Resistance to Antibiotics for the period from 2012 to 2016.

"The only data on the resistance of bacteria to antibiotics that are currently available were published in papers at various professional-scientific gatherings, which are warning. When it comes to methicillin, it is resistant to Staphylococcus aureus (MRSA), while Escherichia coli strains are resistant to third generation cephalosporins. According to these data, in the Clinical Center of Montenegro, in 2010, 59 percent of Staphylococcus aureus strains isolated from different samples were resistant to methicillin. Regarding Escherichia coli, 28 percent of the strains isolated from urine in 2006 were resistant to the third generation of cephalosporins," writes the Strategy.

In order to establish control over use, the authorities recently published clinical guidelines for the rational use of antibiotics, which health professionals are required to adhere to when prescribing drugs.

A prerequisite for establishing resistance control is the establishment of a reference laboratory for resistance monitoring.

This is also planned by the Government's strategy: "The reference laboratory for monitoring bacterial resistance to antibiotics will regularly send reports on the level of bacterial resistance to antibiotics in Montenegro to the National Interdisciplinary Commission for the Control of Antibiotic Resistance (NIKRA). The method of monitoring the resistance of bacteria to antibiotics will be compatible with the European network for monitoring resistance to antimicrobial agents," the government document reads.

The head of the World Health Organization office in Montenegro, Mina Brajović, previously said that resistance is a serious obstacle to the control of infectious diseases, as well as one of the generators of the increase in health care costs.

"We are witnessing that the number of infections caused by resistant pathogens is increasing, while the synthesis of new antibiotics and other antimicrobial drugs is not keeping up with this pace, which gives us good prospects to return to living conditions when a simple lung infection was fatal or when doctors were powerless in the face of meningitis Brajović said.

They will also talk about medicines in schools

According to the plans of the health authorities, the Ministry of Health, in cooperation with the ministries of education and culture and the media, will organize and encourage the organization of promotional and educational activities, in order to draw the population's attention to the necessity of rationalization in the use of antibiotics.

Education about the rational use of antibiotics will be carried out during the training of health workers, but also among the general population, with the aim of spreading awareness about the unjustification of excessive use of antibiotics and the dangers that arise from it.

More harm than good

The Ministry of Health has repeatedly appealed to citizens to use antibiotics correctly.

"Antibiotic-resistant bacteria know no borders, nor do they differentiate between people in any way. Thanks to intensive and fast traffic, they can be easily transported and distributed around the world. Deeply aware of this fact, experts all over the world appeal that the problem of bacterial resistance to antibiotics be taken seriously enough and that both the professional and lay public around the world get involved in solving it", is the opinion of the department of the Minister of Health, prof. Dr. Miodrag Radunović.

Such infections are associated with higher mortality and longer illness of patients. Without effective antibiotics, modern medical treatments, such as surgery, cancer chemotherapy, transplantation, and intensive care are not possible. "Each antibiotic has its own harmful effect that is ignored when there is a justified reason for its use, i.e. when the benefit is greater than the harm. If the antibiotic is used when it is not needed, for example in the treatment of viral infections, it directly harms the body", said the Ministry.