Random prescription, increased exposure to antibiotics and discontinuation of prescribed courses were jeopardising the health of children and making them more vulnerable to diseases, study said.
Hasibul Karim lived with his family in the capital’s Goran area. His seven-year-old daughter Rodela often suffered from cold and cough. Sometimes she would have high fever for four to five days.
Karim went to a pediatrician who prescribed a seven-day antibiotic course for Rodela besides the usual medicines for fever.
‘Children naturally don’t like to take medicine.
It is very hard to complete the seven-day antibiotic course for them,’ Hasibul said.
‘Whenever we force her to take the antibiotic, she begins to cry, compelling us to leave the course incomplete, which I think putting her more at risk,’ Hasibul Karim said.
Antibiotics were very effective in treating infection but it was losing effectiveness through random usage.
According to a research conducted by International Centre for Diarrhoeal Disease Research, Bangladesh, the tendency of buying and taking antibiotics without prescription is growing rapidly.
Many people discontinue the course halfway after they felt slightly better.
The researchers feared that if the practice continued, one day these antibiotics would not work anymore as the intake of inadequate amount of antibiotics was affecting internal organs like kidneys and livers and making human beings vulnerable to various diseases.
There was no statistics on the usage of antibiotics in the country at the national level, but some researchers stated the situation as dire based on surveys carried out by Bangabandhu Sheikh Mujib Medical University and Dhaka University.
In most cases, antibiotics were being used randomly in the case of treating pneumonia in children.
Researchers conducted a research on 80 children aged below five, who were suffering from pneumonia and came to a private hospital in the capital.
Among them, 35.4 per cent were underweight, 17.7 per cent were moderately underweight, and 16.5 per cent were severely under-weight.
On the basis of WHO classification, 54 per cent of the children had severe pneumonia and 46 per cent had very severe pneumonia, as diagnosed by the research physician.
A group of researchers from icddr’b, BRAC and Shaheed Tajuddin Ahmed Medical College Hospital conducted a research to know how much the physicians were following the guideline in treating the pneumonia affected children.
They observed that pediatricians were prescribing antibiotics of the same dose to all sick children without categorising the type of pneumonia they had contracted.
Physicians were even prescribing them high doses of antibiotics without the necessary tests.
The World Health Organisation, in a recent report, expressed fear that microbes were becoming more and more antibiotic resistant through random use, which would cause deaths from minor infection and wounds.
WHO released the report after collecting data from 114 countries across the world.
In the report, researchers mentioned a ‘post-antibiotic era’ where they said that if necessary steps were not taken immediately, it would not be possible to evade disaster.
Despite the WHO pneumonia treatment strategy, the inappropriate use of higher-generation cephalosporin and carbapenem was high in the study hospital.
The results underscored the compliance with the WHO guidelines of antibiotic use and the importance of enforcing regulatory policy of the rational use of antibiotics for treating hospitalised children with pneumonia.
Following these guidelines might help prevent increased antimicrobial resistance.
Paediatrician of Dhaka Medical College Professor M Abid Hossain Mollah referred to the WHO
policy and said that children under five could not intake Azithromycin, a macrolide-type antibiotic which was used to treat a wide variety of bacterial infections.
It was like a crime to prescribe high power antibiotic at the beginning of any disease, as no other
medicine would work further if the antibiotic did not work, said Sir Salimullah Medical College Hospital child specialist Abdul Mannan.
According to WHO, due to antibiotic resistance in people, an estimated 7.5 lakh people died
every year and the number would rise to 10 lakh by 2050 as common infections and minor injuries were claiming lives, raising a concern in the post-antibiotic era.
Emphasising the need for using the proper use of antibiotic, the experts said that the doctors needed to evaluate the effectiveness of their treatment and antibiotic must be prescribed only if needed.

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