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Imagine a world where common diseases like bacterial infection and pneumonia are no longer treatable. This is possible in our near future because of a phenomenon known as antibiotic resistance. As the name suggests, antibiotic resistance is the immunity developed by micro-organisms against antibiotics, making it impossible to kill or inhibit their growth using common antibiotics. Since antibiotics are considered the most effective way to treat diseases and infections caused by bacteria, development of antibiotic resistance is considered a serious threat globally. It is estimated that more than 10 million deaths will be reported worldwide in the near future if no action is taken for tackling the ill/side effects of antibiotic resistance. Hence, it is vital to know the status of antibiotic resistance in each country, as it continues to be a global threat.

Common causes of antibiotic resistance in the United Arab Emirates

• Inappropriate usage of antibiotics – Over or under usage of the prescribed dose of antibiotics is proven to cause antibiotic resistance. This is why it is advisable that patients complete a prescribed dose of antibiotic, even if they are free of the symptoms towards the end of the infection. Antibiotics can also be used for treating bacterial infections in animals and in the agricultural sector. However, misuse of antibiotics in these sectors can also lead to the development of a wide variety of antibiotic resistant strains of bacteria, which eventually may negatively affect human beings.

• Misdiagnosis – Taking antibiotics for viral and fungal infections will not be helpful and may lead to develop antibiotic resistance in our body. Some clinics and pharmacies dispense antibiotics to cut down the testing time for diseases they suspect might be bacterial. This is highly discouraged. Proper testing must be done before diagnosing bacterial infections and providing the optimal dose of antibiotics recommended.

• Lack of knowledge – Antibiotics are made to kill or inhibit the growth of specific kinds of bacteria. Self-prescription is one of the leading causes of antibiotic resistance. According to a recent survey, 48% of the UAE population had poor knowledge about antibiotics usage. They were unaware of the basic knowledge about antibiotics like their usage is only limited against bacterial infections and not for viral infections, the accurate dosage, etc. Thus, wrongly self-prescribing antibiotics for diseases like common cold, which is caused by a viral infection, can contribute to the development of antibiotic resistance.

• Lack of proper infection control policies and global surveillance – Lack of proper control measures in highly infectious conditions like hospitals and research laboratories can lead to the accidental spread of antibiotic resistant variants and can cause widespread infections. Without proper infection control policies, antibiotic resistant strains of bacteria can be found in almost all people, which makes antibiotic resistance a worldwide health emergency that requires global surveillance.

• Insufficient initiatives for new antibiotic agents – Research for finding new antibiotics against the current antibiotic resistant bacteria requires funding and manpower. Agencies, along with their other projects, must also focus on developing new and effective antibiotics.

Consequences

• High treatment time and expenses – Since the presence of antibiotic resistant bacteria can turn a treatable infection to an untreatable one in certain circumstances, the treatment can take more time and can result in more expenses. Some infections can even be incurable and fatal later on.

• Spread of antibiotic resistant variants – As we are aware, most bacterial infections are communicable; the spread of antibiotic resistant bacteria can cause antibiotic resistance bacterial infections in the community. This is dangerous, especially for immunocompromised patients like cancer patients, organ transplant recipients, etc. Since UAE, like other GCC countries, see heavy tourism and travel annually, the spread of antibiotic resistant variants are well noted in the region.

Ways to combat antibiotic resistance

• Awareness – A recent study conducted in Ras Al Khaimah showed that the level of knowledge about antibiotics among the general public is poor. More than 50% of the population believes that viral infection can be treated using antibiotics, which is not the case. 50% of the common public believes in taking fewer antibiotics than the prescribed dose, as they feel revived from diseases. Thus, creating awareness about the importance of taking the accurate dose of antibiotics as prescribed by a physician, and being careful to finish the prescribed dose, can be the first step to combat antibiotic resistance. This can be achieved by providing educational awareness programs at schools and universities and among the public.

• Pharmacies – Pharmacies are to dispense antibiotics only when a person presents a prescription from a physician and should be careful to provide the right dose and amount as prescribed.

• Regulations – Regulating the amount and the types of antibiotics used in the husbandry sector is equally as important as regulating the use of antibiotics in human beings. Using antibiotics for practices like promoting the growth of animals should be banned. Although policies and regulations address this issue, they should be implemented effectively worldwide. National and international committees should take the necessary steps to create the necessary impact.

• Research – More research is to be done to discover newer antibiotics against antibiotic resistant bacterial strains. This requires more funding. Public and private organizations should be aware of this issue and should provide more attention to it.

• Sanitation and healthcare practice – Protecting ourselves from being exposed to harmful infections by performing the correct sanitary practices like washing hands properly, wearing masks around a sick person, etc., can prevent the spread of antibiotic resistant variants. Health care professionals must take the necessary steps to avoid the development of antibiotic resistance and its spread among the public.

Cijo Vazhappilly is the Assistant Professor of Biotechnology at the American University of Ras Al Khaimah. He received his Ph.D. in Cancer Biology from the Vellore Institute of Technology, India. His research focuses mainly on the development and identification of novel potent molecules either from natural or synthetic origins as anti-cancer agents.