Antibiotics in the age of Covid: Which have already lost their effectiveness due to their irrational use? What are “reserve antibiotics” and why are many antibiotics sold without a prescription?
Treatment of coronavirus infection has once again stirred up the problem of rational antibiotic therapy. Despite the fact that now they are already talking about the inadmissibility of treating the crown with antibiotics from every iron, the public continues to gnaw on azithromycin, levofloxacin, amoxiclav, stromectol, ceftriaxone with perseverance worthy of better use.
How serious is the problem of proper use of antibiotics?
The problem is very serious. The first antibiotics appeared in the middle of the XX century; penicillin, invented in 1928, was actively used during the Second World War. In the first years, they treated almost any infection, up to sepsis with peritonitis. Very soon, the bacteria began to “adapt” to their “killers”, in medical language this is called the phenomenon of “antibiotic resistance”.
We have to invent more and more new antibiotics, a dozen years pass — and resistance to them is formed. In order not to disable all the drugs at once, medical associations agreed that antibiotics should not be used randomly, according to the principle “I am an artist, I see it this way”, but “from simple to complex” and taking into account sensitivity to the alleged pathogens. This is how the section of clinical pharmacology called “rational antibiotic therapy” was born.
How many antibiotics have we already lost due to their disorderly use?
It’s hard to say. Probably, even if we used them “decently”, resistance would still form. But the fact remains. The” park ” of antibiotics is constantly being updated. Of those drugs that were twenty-five years ago, only a few remained in practical use. Of course, some of the old men are still in the ranks, but for very narrow indications. For example, classical penicillin can still treat streptococcal infections — sore throat, erysipelas, biseptol is treated for pneumocystis pneumonia in HIV infection, streptomycin-tuberculosis. Amoxil is also still relevant.
What defeated diseases can return to people?
It cannot be said that some diseases were completely exterminated thanks to antibiotics. In fact, the only really defeated disease on the planet is smallpox, but the merit of winning over it is not antibiotics, but vaccines. Rheumatism is much less common, but even here, most likely, it’s not about antibiotics, but about a mutation of streptococcus, which in the current assembly has forgotten how to”bite the heart”.
The problem is different. We get new versions of old diseases that can no longer be treated with classical drugs. This is very clearly seen in the example of tuberculosis. It used to have to be treated for a long time with a combination of three or four drugs, and now the classical schemes help less and less. The problem of” multi-resistant ” tuberculosis, or tuberculosis with widespread drug resistance, is extremely relevant in many countries of the world.
And, of course, we must remember about the complications of antibiotic therapy. This is not only a harmless diarrhea that passes independently after stopping treatment, but also severe, sometimes life-threatening complications. For example, as a result of a shift in the microbiological balance, a special type of clostridium can multiply in the intestine, which causes a serious disease — pseudomembranous colitis, for the treatment of which other, more powerful antibiotics are used.
Today, antibiotics are also prescribed for coronavirus, for example, azithromycin
This is a monstrous misconception. This is partly due to the classical idea that pneumonia (pneumonia) should be treated with antibiotics. Traditional bacterial pneumonia is necessary, but after all, with COVID-19, lung damage is viral, and antibiotics do not work on viruses. Many doctors argue like this: “But a viral disease can be complicated by the addition of a bacterial infection, so we prescribe antibiotics to prevent a secondary infection.” And this statement is incorrect. Unfortunately, the early administration of antibiotics does not prevent the attachment of a bacterial infection; moreover, if the infection does join, it will be more severe and will require the use of more powerful second-or third-line drugs.
That is why all recommendations for the treatment of coronavirus infection emphasize that antibiotics should be prescribed only when there are convincing signs of a bacterial infection, and not just because of a high temperature.
As for azithromycin, they tried to use it not as an antibiotic, but as an anti-inflammatory drug in addition to hydroxychloroquine. However, clinical studies have shown the inconsistency of this idea.
Antibiotics in the age of Covid: Why are they sold without a prescription
Why are they sold without a prescription? Yes, because it is profitable and convenient for everyone. It is convenient for the doctor — there is no need to waste time on processing another document. It is convenient for the patient — there is no need to go to the doctor. It is profitable for the pharmacist — any additional profit is good. It is profitable for a pharmaceutical company — more sales, more income. We remind you that it is dangerous to self-medicate!