MOSCOW, November 23. Unreasonable use of antibiotics in animal husbandry and lack of drug discipline in humans lead to a serious problem of microbial resistance to antimicrobial drugs. This opinion was expressed in a conversation with a correspondent by the famous epidemiologist, corresponding member of the Russian Academy of Sciences, head of the laboratory of infections associated with the provision of medical care, Central Research Institute of Epidemiology of Rospotrebnadzor Alexey Tutelyan.
Let us remind you that from November 18 to 24 is World Antimicrobial Awareness Week. It is held under the slogan «Unite to combat antimicrobial resistance.» Antimicrobials – antibiotics – are medicines used to prevent and treat infections in people, animals and plants. WHO named resistance to these drugs as one of the ten global threats to public health around the world.
«The root of the problem of drug resistance lies in the irrational use of antibiotics,” — stated the scientist, emphasizing that people can and must change this.
“Antibiotics are often irrationally used in the agricultural sector, including livestock and poultry farming. In terms of volume, these are the main consumers of antimicrobial drugs, not so much for treating animals and birds, but for stimulating growth, as preservatives and for preventive purposes,” noted Tutelyan .
“The chicken from which we make the broth, of course, does not contain antibiotics in therapeutic concentrations, but it may contain minor (residual) amounts of the drug. It does not have a therapeutic effect, but it stimulates our resistance to antibiotics,” the scientist added.
The second, but no less compelling reason for the emergence of resistance, in his opinion, lies in the frivolous attitude of citizens themselves to medicines. The scientist called this social phenomenon, which has global medical consequences, “everyday non-compliance with medicinal discipline.”
“The coronavirus pandemic, which is gradually turning into a seasonal infection, has shown that in 2019-2020 our citizens bought 50 percent more antibiotics than in the pre-Covid year. Doctors unanimously said that it is impossible to treat a viral infection with antibiotics, but the population continued to buy antibiotics, and the dispensary service of pharmacies in a number of cases did not interfere with this,” noted Tutelyan.
Moreover, according to him, annual monitoring of the pharmaceutical market showed that in 2021-2022 the situation has not changed — the population continued to buy antibiotics.
«The question is: why? In reserve! In many families, this is exactly what happens. Antibiotics, bought just in case, are in the home medicine cabinet, they gradually expire, and eventually they are thrown away. Where? In the trash. Then all this ends up in a solid household waste landfill, and then goes into the soil. From the soil — perhaps it penetrates into plants, into water, into aquaculture (fish), into animal feed… And here we are again faced with minor amounts of the antibiotic, which people end up consume,” explains the epidemiologist.
In this situation, the scientist calls on citizens to exercise basic medicinal discipline.
«»Don't buy too much! An antibiotic can only be taken as prescribed by a doctor, and not when your mother or neighbor advised. The doctor prescribed a course of antibiotic, for example, 20 tablets. He wrote out a prescription. You bought 20 tablets, drank the full course — and that's it! The medicine cabinet is empty, no disposal is required,” he adds.
“Reducing resistance is largely not in the hands of scientists or the search for revolutionary antibiotics, but in the hands of ordinary citizens who must observe basic medicinal discipline,” – the scientist assures, adding that everyone is accustomed to the concept of “competent eating behavior,” but medicinal behavior should be just as competent.
» You cannot take medicines uncontrollably, even for taking herbal extracts there must be a good reason,” he emphasized, adding that the preventive use of drugs is an area that needs to be strictly controlled.
“I agree that the future lies in preventive medicine. Get vaccinated, take vitamins as prescribed by your doctor, put an asterisk under your nose, but always remember that antibiotics are therapeutic, not prophylactic, they are needed only for treatment,” — noted the epidemiologist.
The problem of drug resistance applies not only to antibiotics, but also to antifungal drugs, the scientist says. “Currently, different types of fungi from the genus Candida are resistant to the most common fungicidal drugs, in some cases reaching 80-90 percent,” states Alexey Tutelyan.
According to him, in some situations this can lead to fatal consequences : for example, if a person is in intensive care with “covid” pneumonia, then the addition of a fungal infection increases the likelihood of death by 25 percent.
In his opinion, blocking the ability of bacteria to adapt, in other words, to adapt to the damaging effects of antimicrobial drugs, is one of the promising ways to overcome this problem.
“As a result of the use of antibiotics, the death of the majority of pathogenic microbes that have penetrated our body, and the subsequent normalization of clinical indicators (visible recovery) only masks the recurrence of the disease due to the multiplication of an extremely small number of surviving, adapted microbes,” the scientist explained.
In other words, in his opinion, the amount of bacteria remaining after using the drug is not capable of causing a clinical picture of the disease, but over time these bacteria become more and more numerous, then malaise occurs. At the same time, according to him, part of the bacterial population, due to complex mechanisms, becomes resistant to those antibiotics to which they were previously sensitive.
“This is how resistance spreads, and our developments are precisely aimed at overcoming this path of spread,” – the scientist emphasized, adding that similar studies are being carried out in different countries, and there are already specific drug candidates. He assures that we will soon witness a rapid growth of such drugs, as happened with antibiotics after the discovery of penicillin.
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