The World Health Organisation has developed a tool for classifying antibiotics to help doctors prescribe the medicine in a way that curbs resistance.
The tool, AWaRe — developed by the WHO Essential Medicines List — will help doctors determine which antibiotics to use for the most common and serious infections, which ones should be available at all times in the healthcare system, and those that must be used sparingly or preserved and used only as a last resort. It classifies antibiotics into three groups namely Access, Watch and Reserve.
WHO also aims to increase global consumption of antibiotics in the “Access” group to at least 60 per cent, and to reduce use of the antibiotics most at risk of resistance from the “Watch” and “Reserve” groups.
Using the “Access” group antibiotics lowers the risk of resistance because they target a specific micro-organism rather than several and are less costly because they are available in generic form.
“Antimicrobial resistance is one of the most urgent health risks of our time and threatens to undo a century of medical progress … all countries must strike a balance between ensuring access to life-saving antibiotics and slowing drug resistance by reserving the use of some antibiotics for the hardest-to-treat infections,” said WHO director-general Tedros Adhanom Ghebreyesus.
Currently, it is estimated that more than one in two antibiotics in many countries is used inappropriately.
A 2016 survey in Kilifi County in Kenya found that staphylococcus aureus — which causes pneumonia, meningitis and boils — was 92 per cent resistant to commonly used penicillin and erythromycin.
In July 2018, researchers from the Kenya Medical Researchers Institute raised the alarm over a cholera strain that had “acquired resistant characteristics and therefore was more difficult to treat.
While pathogens are becoming increasingly resistant, the rate at which the pharmaceutical world is developing new medication for bacterial diseases is much slower. The first antibiotic, penicillin, was developed in 1928 and more than 100 compounds have been found since, but no new class has been found since 1987.
Teixobactin, the first new antibiotic to be developed in nearly 30 years, has been found to treat many common bacterial infections but it may not be available in East Africa for the next 10 years.
In the absence of significant investments into the development of new antibiotics, improving the use of antibiotics is one of the key actions needed to curb further emergence and spread of antimicrobial resistance.
There are studies that have also questioned the pharmacological quality of some of the medication dispensed in Africa.
A 2016 study in the British Medical Journal noted that: “Poor storage also increases the risk of degradation of the drug. Degraded medicines contain less than the stated dose.”
When antibiotics stop working effectively, more expensive treatments and hospital admissions are needed, taking a heavy toll on already stretched health budgets.