When we have a sore throat, cough and fever, we take antibiotics. But right to do it? I hear there is a risk of developing antibiotic resistance, what exactly?
Replies Giuseppe Spriano, Head of Unit, Otolaryngology, Institute. Humanitas, Milan
Upper and lower respiratory tract infections rank first for antibiotic use followed by urinary tract infections. It is estimated that half of the Italian population suffers from respiratory tract infections at least once a year; 25% of all medical prescriptions are for antibiotic therapy and in the winter it rises to 75%. But 80% of airway infections are caused by viruses, against which antibiotic therapy is ineffective.
When they are really needed
By now I agree that antibiotics should be used in bacterial pharyngotonsillitis of children under 10 years and in the elderly with bronchopneumonia associated with chronic obstructive bronchopathy. However, these patients represent a small proportion of people. We can estimate that in at least half of the cases it is wrong to administer antibiotics.
As for theantibiotic resistance, we can define it as a defense system of bacteria that protect themselves from the attack of the antibiotic producing enzymes that inactivate or mutate it so that they are not recognized by the drug. Resistance is an inevitable phenomenon. Even when an antibiotic is properly prescribed, ineffectiveness for the onset of resistance becomes inevitable over time. For this we recommend ualways use the same antibiotic as long as it remains effective. Second and third generation antibiotics have been produced precisely to replace ineffective ones, but even the latter should not be used immediately, otherwise resistance also develops towards the latter.
The risks and the role of education
Obviously in inappropriate use the resistance increases and the risks are disastrous. In a report published on The Lancetit is estimated that up to 95% of the adult population of India and Pakistan, one billion people, have developed resistance to carbapenems, third generation antibiotics. In Italy this resistance of about 25%. To counter the problem we must first focus on education: many self-prescribe the unnecessary antibiotic or they use it badly. Doctors know this but in a study it emerged that only one time out of four the doctor is convinced of the usefulness of the drug, the other times he prescribed it at the insistence of the patient. The second way use non-antibiotic drugs. For example those che increases natural defenses o substances that reconstitute the natural defensive barriers by restoring the trophism of the mucous membranes, making them less vulnerable to attack by bacteria.
March 25, 2021 (change March 25, 2021 | 20:47)