The misuse of drugs leaves us defenseless in times of greatest need

Greece has the highest percentage in Europe of microbes that are resistant to antibiotics, according to Professor Nikolaos Legakis of Athens University’s School of Microbiology. «Microbial resistance – that is, the development of microbes’ ability to resist the effect of antibiotics – leaves doctors without any means of treating infections. This is a phenomenon that has reached frightening proportions and occurs worldwide, including in developed countries. The known thing is that once resistance is acquired, it is very difficult to reduce. While once resistance was to one particular antibiotic, now diseases are resistance to a wide range of antibiotics.» For reasons that have not yet become completely clear, this applies mostly to microorganisms that cause serious infections in people with serious diseases.» Microbial resistance is a serious public health problem in Greece, according to the professor. «There is no doubt that it is linked to the consumption of antibiotics, although this is not a simple matter, since it is affected by a number of factors. The restricted use of an isolated antibiotic or its withdrawal for a short period of time usually leads to a reduction in the frequency with which resistant microorganisms appear.» On the basis of these findings, a group of distinguished scientists in Greece and abroad are trying to restrict the use of new antibiotics in every way possible. «Hygiene is of crucial importance in preventing and controlling these infections. Success depends on cooperation among all groups involved in the chain of distribution, such as dentists, pharmacists, veterinary surgeons and nursing staff. Journalists should also help discourage patients from buying antibiotics over the counter without a doctor’s prescription.» Taking antibiotics as a preventive measure at the first sign of a sore throat, cough or fever undermines our health, as it increases the likelihood of contracting an infection from a resistant microbe. «An ordinary cold – stuffy nose and sore throat – that commonly appears at this time of year is usually viral, particularly when of epidemic proportions,» said Dr Georgios Petrikkos, physician, infectious disease specialist and associate professor at Athens University. «Antibiotics are not what are needed here, but rest and staying at home so as not to infect others. The patient should not go to the pharmacy or try and persuade the doctor to prescribe antibiotics. It is known that, in general, resistance affects ecology and microbes. And when the patient later contracts a bacterial infection, the antibiotic may not be effective due to the acquired resistance.» Care must also be taken not to use inappropriate medicines for viral infections of the urinary tract system. Petrikkos cited the example of women taking advanced antibiotics at the first sign of cystitis and without a culture first being taken, when a very simple drug would be effective. «If a third-generation antibiotic is administered and resistance is created, the patient will acquire resistance to all the simpler antibiotics. So, until the infection is diagnosed and a sensitivity test performed, the patient should take a very simple, cheap drug and not an advanced antibiotic. In some cases, such as asymptomatic bacterial infections, antibiotics should only be administered in exceptional circumstances.» Pharmaceutical firms, he added, are focusing their efforts on new antibiotics that cover resistant microbes. «For example, the spread of MRSA has wiped out the anti-staphylococcus penicillins, since the resistant strain in some hospitals in Greece is as high as 40 percent. However, simple antibiotics should be given where possible, also because of the high cost of research into new antibiotics. Only three of at least five substances being tested have anti-microbe action and these concern gram-positive microbes. For certain gram-negative hospital-acquired pathogens (such as pseudomonas or acinetobacter) that have already developed multi-resistance to nearly all antibiotics, there are no prospects for the immediate future. The repercussions are dramatic, for most seriously ill patients undergoing long-term treatment in ICUs are affected by these very microbes and could die as a result.»

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