What doesn’t kill them, makes them stronger

Junior college student Cheryl (not her real name) admitted that she does not always finish every dose of her prescribed antibiotics, even though her doctor always tells her to complete the course.”I don’t stop taking them on purpose, I sometimes forget to finish up the last few doses when I feel well or when I’m busy with school work. I don’t think (not completing the course) will really hurt if it’s just once or twice.” said the 18-year-old.

What Cheryl doesn’t know is that she has unwittingly contributed to the rise of antibiotic resistance.

Worldwide, antibiotic resistance is an increasing health concern. South-east Asia, a hotspot for emerging infectious diseases such as severe acute respiratory syndrome and the recent H1N1, is especially at risk, says professor of public health Richard Coker, in his paper published in this year’s January issue of Lancet.

A recent study shows worrying trends of antibiotic resistance in Singapore.

The Survey Of Antibiotic Resistance (SOAR) study by GlaxoSmithKline looked into antibiotic resistance among three types of bacteria from Singapore.

The SOAR study revealed that the effectiveness of penicillin is decreasing against streptococcus pneumonia (SP) strains in Singapore.

SP can cause infections such as pneumonia, including acute sinusitis, otitis media (middle ear infection), and meningitis (brain infection).

However, the study also found that 98.5 per cent of SP strains can still be treated effectively with other types of antibiotics, namely amoxicillin-clavulanate and amoxicillin.

Dr Leong Hoe Nam, a consultant infectious diseases physician at Raffles Hospital, said that with the increasing antibiotic resistance rate in Singapore, the big challenge facing public healthcare is the need for a concerted effort by both doctors and patients.

Antibiotics work by killing off or preventing bacteria from multiplying.

While they can fight infections caused by bacteria, such as scarlet fever and urinary tract infections, antibiotics do not work on illnesses caused by viruses like most coughs, colds or flu, said Dr Leong.

Dr Leong warned that using antibiotics wrongly – for instance, to treat common colds or flu – can train other bacteria in the body to be resistant to it. “When you do not complete your course of antibiotics, the bacteria can return with the same infection, and may possibly carry resistant genes,” he explained.

Improper dosing may also breed resistance. Dr Leong stressed the importance of using antibiotics correctly.

“Patients must be compliant and finish off the full course antibiotics prescribed. Take it seriously. Don’t miss doses. Do we miss filing our taxes? If we do, there is a penalty! The same goes for antibiotics,” said Dr Leong.

What if you do forget a dose?

Dr Leong advised taking it as soon as you can and continuing as prescribed.