At a time when illness was considered a death sentence,
antibiotics (the first of which was penicillin) revolutionized medicine, curing
various diseases with little to no side effects. However, another problem,
especially in Jordan, has risen with time: the liberal use of antibiotics.
اضافة اعلان
In a general sense, antibiotics interfere with vital
biochemical processes unique to bacterial cells, making their effect on human
cells minimal.
This interference can affect bacterial reproduction,
cellular structure, and integrity or metabolism.
Naturally, bacterial cells evolve to develop mechanisms to
resist antimicrobial agents by modifying their metabolic reactions and cellular
structures. In turn, a phenomenon called antimicrobial resistance came to be,
allowing certain species of bacteria to dodge antimicrobial agents.
This phenomenon has become a major public health
concern.
Jordan: Space for misuse and overuse
In Jordan, antibiotics are available over the counter,
creating a wider space for misuse and overuse.
A study published in Pubmed in 2020 by DH Abdelqader
concluded that most Jordanians resort to self-medication and use antibiotics
without a prescription.
The questionnaire used in the study also showed that most
participants had poor knowledge of the proper usage of antibiotics and found
dangerous practices such as incomplete treatment and unnecessary treatment
normal or unproblematic.
Many people also reported being dissatisfied with a
physician that does not prescribe antibiotics.
The ideal usage of antibiotics
Antibiotics should be used when a bacterial infection is
confirmed or strongly suspected. They can also be employed as a prophylactic
measure to prevent severe conditions after surgery.
It is important to note that antibiotics are ineffective
against viral infections such as the common cold and flu.
Broad-spectrum antibiotics, which affect various bacterial
species, including those beneficial to the human body, can disrupt essential
functions like training the immune system, metabolizing food to produce
vitamins, and protecting against harmful bacteria.
A disruption to the microbiome
When antibiotics are overused or misused, they kill not only
the targeted bacteria but also the beneficial ones, which disrupts the balance
of the microbiome.
The microbiome is a term used to describe the trillions of
bacteria and other microorganisms that live in our bodies.
This disruption can pave the way for the proliferation of opportunistic
pathogens, which are naturally present in the human body but are kept in check
by beneficial bacteria under normal circumstances.
Serious opportunistic infections include pseudomembranous
colitis caused by C. dificile; other infections include fungal infections of
the lung, oral cavity, and urinary tract.
Moreover, studies have shown that the overuse of antibiotics
can reduce the microbiome's diversity, completely wiping out certain bacterial
species. This dysregulates the immune system, as the microbiome plays a crucial
role in training it to recognize and respond appropriately to different
pathogens.
Without this training, the immune system may overreact to
harmless substances, leading to the development of allergies and autoimmune
diseases.
Two studies published in Pubmed in 2018 and 2020 reported
that children exposed to antibiotics during their first year had a higher risk
of developing multiple conditions such as asthma, allergic rhinitis, food
allergies, and hay fever.
In addition to allergies, the overuse of antibiotics has
been linked to an increased risk of autoimmune diseases such as inflammatory
bowel disease, rheumatoid arthritis, and multiple sclerosis, to name a
few.
The exact reason why these conditions develop is still being
studied. Still, there are multiple indications that the microbiome plays a
crucial role in developing and regulating the immune system. Disruption of this
balance can lead to an overactive immune system that attacks the body's
tissues.
A study conducted in Jordan found that the prevalence of
autoimmune diseases is rising, with allergies being the most common.
According to the Ministry of Health, Jordan has a high
prevalence of antibiotic resistance, especially in gram-negative bacteria such
as Escherichia coli and Klebsiella pneumonia, the spread of these resistant
strains can lead to chronic infections that are difficult to treat, and these
stubborn infections are becoming an increasingly challenging issue to Jordanian
doctors.
The gut knows best
The microbiome is known to play a crucial role in many
physiological processes, including digestion, immune function, and even brain
function.
Recent research has highlighted the relationship between the
microbiome and mood and psychological well-being. In particular, the gut
microbiome has been shown to influence the levels of neurotransmitters, such as
serotonin, which are crucial for regulating mood and behavior.
Antibiotics can have a significant impact on the microbiome
and, consequently, on mood and psychology.
Broad-spectrum antibiotics can disrupt the delicate balance
of the gut microbiome, reducing the diversity of bacteria and altering their
composition.
This disruption can affect the production and regulation of
neurotransmitters, such as serotonin, which are crucial for mood and behavior.
Serotonin is often referred to as the "feel-good" hormone, as it is
associated with feelings of happiness and well-being. In fact, around 90
percent of serotonin is produced in the gut, highlighting the importance of a
healthy microbiome in regulating mood.
Disruption of the microbiome through antibiotics can lead to
imbalances in serotonin levels, potentially leading to mood disorders such as
depression and anxiety.
Room for hope
A cross-sectional study published in 2021 concerned with the
change in the Jordanian public’s awareness about antibiotics between 2010 and
2018 has shown an improved understanding of certain aspects, such as the use of
leftover antibiotics, and improved general knowledge about antimicrobial
resistance.
Awareness about other harmful practices, such as
self-medication with antibiotics, was not affected during that period.
To address the issue of overuse and misuse of antibiotics in
Jordan, there needs to be tough regulations put in place.
One possible regulation is to remove the over-the-counter
status of antibiotics, which would require patients to have a prescription from
a healthcare provider to obtain antibiotics.
Being a common practice in many countries, the Kingdom could
help reduce the amount of self-prescribed antibiotics to a more responsible
usage that would require physician recommendation.
However, this also leads to another important part of the
issue, managing how healthcare providers contribute to developing antibiotic
resistance.
This can be done by implementing educational programs for
healthcare providers on appropriate antibiotic prescribing practices and
increasing monitoring and accountability for antibiotic prescribing.
Furthermore, there is a need to improve the quality of data
on resistance patterns.
It is also important to acknowledge the role of
pharmaceutical companies in perpetuating the problem of antibiotic
resistance.
The profit-driven nature of the industry can incentivize the
development and marketing of broad-spectrum antibiotics, which can contribute
to the development of resistance.
Therefore, there is a need for increased regulation and
accountability for pharmaceutical companies to promote the development of new
antibiotics that are targeted and effective while also promoting the
responsible use of antibiotics to preserve their efficacy for future
generations.
Read more Health
Jordan News
.jpg)
.jpg)
