Antibiotic resistance growing31st March 2008
Lack of regulation in developing countries is contributing to sharp growth in resistance to antibiotics.
The proliferation of counterfeit drugs, poor prescribing practices are also contributing to the problem.
Resistance has been around as long as antibiotics have, and to a certain extent is a global problem.
Nonetheless, even everyday infections are now showing resistance to antibiotics in some poorer countries, according to experts in China, India and Africa.
In China, a national working group of experts who are monitoring the problem say that about 60-70% of common bacterial infections, like E coli and Pneumococcus, are now caused by resistant forms of the bacteria.
Xiao Yonghong, deputy director of the Institute of Clinical Pharmacology at Peking University in Beijing, blames the problem in China on the widespread overuse of antibiotics, estimating that around 30% of drugs sold by hospital pharmacies are antibiotics.
In developed countries that proportion is just 10%.
Doctors in China will frequently chop and change a patient's antibiotics if the first prescription is not having the desired effect.
According to Gao Zhancheng of the Department of Respiratory and Critical Care Medicine at Peking University's People's Hospital, the problem stems partly from the poor diagnostic capability of most the country's clinical laboratories.
Doctors will frequently prescribe a broad-spectrum antibiotic because they are unsure which exact pathogens are involved.
The problem of accurate pathology is even more acute in India, which lacks widely available laboratory testing. Where lab facilities do exist, they are often of a very poor quality.
Doctors are forced to prescribe medication without knowing what exactly is causing the disease, or whether it is drug-resistant.
Either lab results are unreliable, or they take too long to produce, and doctors are unable to wait in urgent cases like pneumonia.
If antibiotics are not used correctly, for example if the prescribed course is not completed, or if the medication is switched halfway through treatment, they fail to kill all the bacteria. The remaining bacteria are then able to develop resistance to the drug.
In the case of infectious diseases, a resistant strain of bacteria soon emerges, ruling out further treatment with a specific antibiotic.
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