Once upon a time there were lots of magic molecules around us to combat bacterial infections. They were totally used to defend us from mild to sevear infections. After sometimes these molecular options were narrowed day by day. Now this decade is going to threat us by snatching our magic molecules from us. Just like an Iron mam without his AI suit our strength against infections will be reduced to more than half. The antibiotic resistance is spreading all over the world and most of bacterial cells are boosting their own immunity to be superbugs. We are aware of the the horror show with antibiotic resistance. Corona virus pandemic has accelerated this resistance in short time. The door was already opened for superbugs is now widen by this novel virus. Corona virus has emerged as a best friend of bacteria now a days.
How is corona triggering antibiotic resistance?
As we all know very well Corona is a viral disease and antibiotics don't work on it. But that is just a half truth. Actually we need antibiotics each time whenever the infection word is coined. Yes, whatever infection it may be, there should be a bunch of antibiotics we should have in spare to control the condition. Every infection makes our body weak and opens the probability for other microbes which are mostly bacteria. In such case this infection is called secondary infection and to control the double damage we must need antibiotics.
The same thing happened in this pandemic. Some studies have found that 1 in 7 patients hospitalized with Covid-19 has acquired a dangerous secondary bacterial infection, and 50% of patients who have died had such infections. That means the virus opens the loop hole of our immune system and the bacteria take advantage of it. In this case especially in ICUs patients are administered heavy antibiotics to survive. It's ok when the matter is all about saving lives but In asymptomatic patients there are also antibiotics are administered forcefully as prophylaxis. Especially in developing countries like India, Azithromycin is widely used to treat the primary symptoms of corona and sometimes without any symptoms the drug has been swallowed for the purpose of prophylaxis. This type of practice is provoking the monster of resistance.
The 2009 H1N1 influenza pandemic, for example, claimed nearly 300000 lives around the world. Many of those deaths (between 29% and 55%)were actually caused by secondary bacterial pneumonia. The patients at greatest risk from superbugs are the ones who are already more vulnerable to illness from viral lung infections like influenza, severe acute respiratory syndrome (SARS), and Covid-19. So the corona is not the only challenge we are facing. We are also facing the another parallel challenge is antibiotic resistance. Our best weapons are limited and not working in such terrific condition. We are ignoring this silent pandemic destroying us simultaneously. Antibiotic resistance hasn’t gotten our attention yet in the same way that Covid-19 has. It's rising as a global menace.
In some countries physicians are experimenting with amoxicillin, tetracycline, doxycycline, and teicoplanin, a last-resort drug used against MRSA, to try to prevent coronavirus infections. It directly means that our agenda to combat corona virus is just based on the trial and error methods on patients. Without proper research we have to use all these tricks to survive and obviously we haven't enough time to rethink on it. That is how we're trapped in.
How can it be tackled?
The Covid-19 pandemic has highlighted the importance of vaccination, the need for functional antimicrobials, as well as the necessity for supporting research into the understanding and control of infectious agents. As we know the research pipeline isn't enough strong to provide us the future hope for new antibiotics, the vaccine would be the next target to immune our system from such viruses. If we can't fix the cause by invention of vaccines, we'll suffer with such silent pandemics.
In developing countries like India substandard and counterfeit drugs have added fuel to this fire, and increased drug resistance (fake or substandard drugs with some but not enough real drug content so the bacteria aren't destroyed but learn to recognize and resist). Quality medicines is the base to temper the superbugs but unfortunately we are facing this situation especially in government sectors where drugs aren't tested for their contents properly and sometimes testing results are so late when most of the drugs have been consumed by the population. This kind of mistakes are adding the trouble in this vital situation.
In the current scenario appropriate and systematic testing of Covid-19 patients presenting with a bacterial co-infection should be conducted in order to choose the correct antibiotic to increase the survival of patients and limit the spread of AMR. Though it's easy to say, hard to implement. Especially where Covid-19 tests are not performed enough for the population, how can we expect the bacterial strain testing simultaneously?
We can’t predict when or where the next pandemic-triggering virus will emerge, but we can predict that secondary bacterial infections will follow. To fight these superbugs we desperately need new antibiotics. All the aspects should be considered while thinking about such pandemic because pandemic comes with lots of soldiers with them to destroy us from all the directions.
Science is all about facts as well as uncertainty but the robust and rigorous efforts can uplift us up to the mark. We have least hope for new antibiotics and the current currency is totally being banned for the usage. But without losing hope we must shape our ideas to rebuild the new strategies against such pandemics and antibiotic shortages. Afterall necessacity is the mother of invention.
I hope that COVID-19 will be a great learning experience in the shortfall of antibiotics.
Final Funda: The way we have to use millions of PPE kits everyday, the next plastic pandemic to contaminate the climate is waiting for us.
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