Rational use of Antibiotic

• There is a need to improve rational use of

antibiotics in Africa.
• Antibiotics are life savers.
• No new antibiotic has been discovered in the
past few years.
• Antibiotics we have currently are limited in
stock.
• If depleted, there will be nothing left for us to
use
Factors contributing to irrational use of
antibiotics
• Irrational use is not helped by self-purchasing
of antibiotics which is common in Africa .
• Greater accessibility to antibiotics has
contributed to their irrational and excessive
use leading to increasing antimicrobial
resistance (AMR), a decline in effectiveness
and strain on health –care systems.
 Examples of irrational use of
antibiotics
• Using longer courses than necessary
• Unnecessary use of combinations where a
single drug would be equally effective.
• Use of broad- spectrum antibiotics where a
narrow spectrum agent is indicated.
• Prophylactic use of antibiotic without any
proven benefit.
• Continuous use of parenteral antibiotics
instead of oral switch.
 AMR outcomes
• Increase in mortality -It is estimated that AMR
infections currently causes approximately 50,000
deaths a year in Europe and US alone, increasing
to several hundred thousands when other
countries are included.
• The continual rise in AMR could result in infection
that are resistant to antibiotics becoming a
leading cause of death by 2050, with a clear link
between overuse of antibiotics and AMR
• Prolonged Hospital Stay.
• In some hospitals in Africa , antibiotics
account for up to 35% of medicine
expenditure.
• There are some concerns and issues with
antibiotic prescribing in Botswana for example
prescribing antibiotics for URTI which requires
just cough mixture
.
 Factors that drive AMR
• Indiscriminate use of antibiotics e.g areas with
highest resistant rate also have highest
antimicrobial use
• Gene transfer between bacteria
• Travel
• Poor sanitation & hygiene
• Decrease in antibiotic development.
• These factors influence the development of AMR
jeopardizing the health of individual and society.
 Way forward
• There have been combined activities in Botswana
to improve the use of antibiotics including the
development of antibiotic guideline and other
measures like strict policy however, research has
shown that guideline are not always followed.
• We need to document resistance patterns
• Plan future research activities since without such
studies planning is difficult.
• Development of infection control committee