01 Nov 2010
A runny nose is all it takes to send some people rushing to the doctor for antibiotics.
But demanding them every time you have the common cold undermines the body’s ability to fight more serious infections in the future.
Your immune system helps you fight infections such as colds by creating a barrier that prevents bacteria and viruses from entering the body, or detecting and getting rid of bacteria or viruses if they do. Viral and bacterial infections are the most common causes of illness for most people.
Antibiotics do not work against viruses, so using them for viral infections such as colds and coughs can cause antibiotic resistance. “Using antibiotics regularly for something they cannot treat can make them less effective against the bacteria they are actually meant to treat,” said Dr Andrea Kwa, Pharmacy Clinician Scientist, Department of Pharmacy, Singapore General Hospital (SGH).
She said: “In addition, antibiotics should be used to treat an infection and not prevent one.” She advised patients not to use leftover antibiotics as these may not be suitable for their current condition or may have expired.
Resistance to antibiotics can also occur when we do not complete the prescribed course when there is a bacterial infection. “When this happens, we’re actually giving the bug enough time to rest, reproduce and come back with a vengeance,” said Mr Lim Tze Peng, Senior Research Pharmacist, Department of Pharmacy, SGH.
Since careful use is necessary to prolong the life of antibiotics and to slow the spread of antibiotic resistance, Dr Kwa and her colleagues formed a multidisciplinary team to study how antibiotics are prescribed. Said fellow team member Ms Winnie Lee, Principal Clinical Pharmacist, Department of Pharmacy, SGH: “We work with physicians to ensure the right antibiotic is used – in the right amount and for the right duration.”
The team, in partnership with various infectious disease healthcare practitioners, has proposed to the Ministry of Health to make the programme mandatory in all healthcare institutions – to build a nationwide effort in controlling antibiotic resistance among the local community.
Besides managing the programme, the team also monitors the behaviour of bacteria.
If a bacterium no longer responds to a standard treatment, the team looks to new therapies that combine different antibiotics.
This is because there are no new formulas in the research pipeline for difficult to treat infections for the next five to 10 years.
While the vast majority of patients will not require this option, those whose immune systems are too weak to fight off infections will benefit. Such patients include those who have undergone organ and bone marrow transplants or cancer treatment, but they form a relatively small percentage of hospital patients.
Identifying the right combination of antibiotics for treatment can take some time. Due to this, Mr Lim and his colleagues are also looking to develop a test that can quickly guide doctors in the appropriate antibiotics combination at the onset of such infections – which can be fatal if the right treatment is not started within 48 hours.
“If we can secure grants to develop this area, we hope to improve the turnaround time for research in combination therapies from seven days to two days. This means we’ll be able to tailor the antibiotic combinations for patients even more,” said Mr Lim.
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Dept of Pharmacy
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