Child health in jeopardy over random use of antibiotics


DHAKA, Feb 12, 2019 (BSS) – Hasibul Karim lives with his family in
capital’s Goran area. His 7-year-old daughter Rodela suffers from cold and
cough often. Sometimes she gets high fever lasting four to five days. Karim
went to a pediatrician, who prescribed seven-day antibiotic course for Rodela
alongside normal medicine for fever.

“Children naturally don’t like to take medicine. Moreover it is very hard
to complete the seven-day antibiotic course for them. Whenever we force her
to take the antibiotic, she began crying, compelling us to leave the course
incomplete, which, I think, is creating more risk for her,” Hasibul Karim

Antibiotics are very effective to treat infection, but it is losing its
effectiveness through the random use.

According to a research conducted by International Centre for Diarrhoeal
Disease Research, Bangladesh (icddr’b), the tendency of buying and taking
antibiotics without prescription is growing rapidly. After feeling a little
better, many people stop the course on its halfway.

The researchers fear that if this bad practice continues, one day these
antibiotics will not work anymore as the intake of inadequate amount of
antibiotics is affecting internal organs like kidney and liver and making
human beings vulnerable to various diseases.

There is no statistics on the use of antibiotics in the country on
national-level, but some researchers based on surveys carried out by
Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka University
stated the situation as dire.

In most cases, antibiotics are being used randomly in the case of treating
pneumonia in children.

Researchers conducted a research on 80 children aged bellow five, who were
suffering from pneumonia and came to a private hospital in the capital.

Among them, 28 (35.4%) were underweight, 14 (17.7%) were moderately
underweight, and 13 (16.5%) were severely under-weight.

On the basis of WHO classification (2005), 43 children (54%) had severe
pneumonia and 37 (46%) had very severe pneumonia, as diagnosed by the
research physician.

A group of researchers from icddr’b, BRAC and Shaheed Tajuddin Ahmed
Medical College Hospital conducted a research to know how much the physicians
are following the guideline in treating the pneumonia affected children.

They observed that pediatricians are prescribing antibiotics of same dose
to all the sick children without categorizing their type of pneumonia.
Physicians are even prescribing them high dose of antibiotics without any
necessary test.

World Health Organisation (WHO) in a recent report expressed its fear that
the microbes are becoming more and more antibiotic resistance though random
use, which will cause death from minor infection and wounds.

WHO released the report after collecting data from 114 countries across
the world. In the report, researchers mentioned about ‘post-antibiotic era’,
where they said if necessary steps were not taken immediately, it would not
be possible to evade the disaster.

Despite the WHO pneumonia treatment strategy, the inappropriate use of
higher-generation cephalosporin and carbapenem was high in the study
hospital. The results underscore the compliance with the WHO guidelines of
antibiotic use and the importance of enforcing regulatory policy of the
rational use of antibiotics for treating hospitalized children with
pneumonia. Following these guidelines may help prevent increased
antimicrobial resistance.

Paediatric of Dhaka Medical College Professor M Abid Hossain Mollah
referring to the WHO policy said children under five cannot intake
Azithromycin, a macrolide-type antibiotic which is used to treat a wide
variety of bacterial infections.

It is like a crime to prescribe high power antibiotic at the beginning of
any disease, as no other medicine would work further if the antibiotic did
not work, said Sir Salimullah Medical College and Hospital child specialist
Dr Abdul Mannan.

According to WHO, due to Antibiotic resistance in people, there is an
estimation over 7.5 lakh people die every year and the number will raise to
10 lakh by 2050 as common infections and minor injuries are claiming lives,
raising a concern in the post-antibiotic era.

Emphasizing the need for using the proper use of antibiotic the experts
said the doctors need to evaluate the effectiveness of their treatment and
antibiotic must be prescribed only if needed.