Increasing use of antibiotic in human , agriculture and animals lead to have acquired antibiotics resistance in developing countries and it is not restricted to developing countries, it growing worldwide to be one of the most serious problem to global public health. In the U.S it might be the more common cause of deaths by single multi resistant bacteria species than deaths caused by AIDS . (1)
Root Causes of resistance in many developing Countries
This explosive growth of resistance in developing countries is particularly serious for the following reasons (2) :
- In many Countries , antibiotics can be obtained from other recommended treatment center , and can take it without supervision or at least medical authorization. This lead to inappropriate use of antibiotics and their being taken at sup-optimal dosage and for an insufficient length of time. About 109500 doses had been dispensed by pharmacies, and more than 100 000 doses had been dispensed without a prescription (3 الارتكليز)
- There are some fake drug , sub-standard , or expired they can be obtained from local market .
- Often the high cost of an antibiotics , result in an incomplete course being purchased , sufficient only to relive symptoms .
- Insufficiently informed the patient about antibiotics and how they use it .
- Guidelines the : selection of drug , correct prescribing , and information about drug resistance and how to minimize it is spread are not communicated to those purchasing and prescribing antibiotics .
- Antibiotics are often prescribed for patient when they are not much needed or for self limiting infection as in : diarrheal disease , viral respiratory infection .
- Often prescribe the antibiotics have are broad spectrum e.g. tetracycline drug .
- Isolation of pathogen also accurate diagnosis need for laboratory facilities and they are often not available in developing countries and this can lead to inappropriate use of antibiotics .
- Some factors facilitate spread of organism such as : overcrowded and poor hygiene and sanitation e.g. bacteria that cause tuberculosis or typhoid and pneumonia .
- Inadequate infection control procedures in hospitals lead to spread of infection diseases and resistance strain of organism such as : staphylo aureus , Pseudomonas aruginosa , E.coli . pneumonia klebsiella , proteus , Enterococcus and salmonella seovars .
- Training and facilities for performing standardized antimicrobial susceptibility test are often lacking in many countries ,they do not have effective surveillance .
- Unable afford costly second-line antibiotics to treat infection due to resistance organism in developing countries that lead to prolonged illness with longer period of infectivity and further spread of resistant strains .
Future holds of resistance in developing countries
Which lead to increase attention to the problem of resistance in developing countries is that the resistance in developing countries could affect the industrialized countries . There are controlling program in future in developing countries to diminishing global problem by requiring to appropriate use of antibiotics agents and improving the social and environmental conditions in poor of developing countries that may cause the high incidence of infectious diseases. Evidence of improved socioeconomic standards and disease prevention in many countries it is for the first time worldwide deaths of children under age 5 have
dropped to below 10,000,000 due to increased access to childhood immunization, and the development of new vaccines against common infectious diseases . Public health priority it has been now identify as controlling of resistance in developing countries , where centered efforts to control resistance by ensuring the appropriate use of antibiotics agents include :
- Good knowledge of caregivers .
- Imposing regulatory controls for caregivers and pharmacies during prescribe antibiotics .
- Management systems to ensure that regulations are implemented .