What are antimicrobials?

This is the name given to the broad group of medications given to treat or prevent infections caused by bacteria, fungi, or parasites.

An Antibiotic drug like Amoxicillin (Amoxil) is a type of antimicrobial which is used to treat upper respiratory tract infections such as bronchitis or tonsillitis.

The overuse of antibiotics worldwide in recent years means they are becoming less effective and has led to the emergence of antimicrobial resistance. These are strains of bacteria that have developed resistance to many different types of antibiotics.

So what is the main problem related to antimicrobial use in our country right now?

Antimicrobial Resistance (AMR)

Antimicrobial Resistance occurs when bacteria, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death. 

The global situation is so serious that clinicians are not only concerned about bacterial resistance to one drug, but several drugs. Hence, the term Multidrug Resistance (MDR) is used. As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat. In St. Vincent and the Grenadines, there is an urgent need for an antibiotic stewardship program and strict compliance with developed treatment algorithms.

What causes this problem?

Antibiotics require a prescription from a registered physician but some clients often obtain access to them without a valid prescription leading them to misuse the medicines. Overtime, drug resistance develops and the infection no longer responds to medicines or it becomes more difficult to treat. This drug resistance can lead to worsening of the disease or condition, disease spread or even death.

Microbes, such as bacteria, viruses, fungi, and parasites, are living organisms that evolve over time. Their primary function is to reproduce, thrive, and spread quickly and efficiently. Therefore, microbes adapt to their environments and change in ways that ensure their survival.

Antimicrobial resistance is one of the biggest public health challenges of our time.

Persons could be taking the wrong antimicrobial agent believing that it is working, or they could be self treating with the same antibiotic in particular, that they might have used for a similar problem five months ago without the knowledge that the resistant bugs have changed to an infection which is potentially more serious. In such a case, the current treatment may do more harm than good. The situation may be referred to as “supercharging the superbugs”. The choice of antimicrobial by a prescriber is also of critical importance.

The biggest worry is that new strains of bacteria may emerge that cannot be treated by any existing antibiotics.

The way forward

To combat this problem some countries have instituted antimicrobial stewardship programs (AMS) which coordinate quality improvement strategies designed to encourage the appropriate use of antimicrobial agents.

An AMS program aims to promote prudent, effective prescribing through optimization of antimicrobial selection, dosage, duration of treatment, route of administration and promote cost-effective prescribing.

Antimicrobial resistance could cause grave consequences for the future. Without meaningful change AMR is predicted to become the leading cause of death worldwide by 2050.

The SVGPC is of the view that urgent action must be taken to tackle the issue of Antimicrobial resistance in St. Vincent and the Grenadines. In its remit, the Council will work with the Pharmacy and Therapeutics Committee and other health bodies to examine the main causes of the problem locally, and contribute to the development of an effective and comprehensive stewardship program to address the proliferation of the overuse and misuse of antimicrobials in St. Vincent and the Grenadines.

Submitted by: The St. Vincent and the Grenadines Pharmacy Council (SVGPC).