The danger of increasing drug resistance

Patients live half-lives, half-die

At Nghe An General Hospital, there are dozens of patients hospitalized each year due to drug poisoning. Most of the patients have severe damage to the liver, kidneys or other parts of the body, with a high risk of death. There are also cases of “half-living, half-dying”, carrying the disease for life due to drug resistance.

Master, Doctor Nguyen Van Thuy, Head of the Poison Control Department, Nghe An General Hospital said: Many cases of poisoning and drug allergies due to not using the drug as prescribed by the doctor have occurred. Many cases of treatment have not been cured, only through testing can it be discovered that the patient has multi-antibiotic resistant bacteria.

Recently, the hospital admitted a patient with difficulty breathing, a history of heart failure, and high blood pressure. After 3 weeks of intensive treatment, the patient still had to be on a ventilator and had a high fever. This patient had drug-resistant pneumonia and was resistant to all available antibiotics. Whether the patient could recover or not could only depend on his own immune system.

According to Dr. Nguyen Van Thuy: Antibiotic resistance is likely to occur in people with chronic diseases, susceptible to infections such as people with a history of diabetes, gout. These people have arbitrarily used antibiotics for treatment many times... For patients with diseases caused by antibiotic-resistant bacteria, the mortality rate is much higher than normal patients, from 30-90%. Especially with diseases caused by multi-drug resistant bacteria, the mortality rate is up to 99%.

There are many reasons leading to antibiotic resistance, which are: People using antibiotics indiscriminately without a doctor's prescription, believing and using drugs according to "online doctors". People using antibiotics widely, for a long time, and abusing them in livestock, poultry, aquaculture and crop farming.

In addition, there are doctors in private clinics who want patients to recover quickly, so they give them a very broad spectrum of antibiotics that kill many types of bacteria, causing the bacterial population to change and mutate genes to resist broad-spectrum antibiotics. There are situations where pharmacists also act as doctors to consult, examine, treat, prescribe and sell antibiotics indiscriminately. There are situations where traditional healers use old-generation antibiotics to make pills and powders to sell to patients.

Antibiotic resistance does not only occur in adults, but sadly, the number of children resistant to antibiotics is increasing. Master, Doctor Bui Anh Son, Head of the Respiratory Department of the Obstetrics and Pediatrics Hospital, informed: The hospital has participated in the topic of antibiotic resistance in children under 5 years old. After 2 years of implementation, 600 patients were selected for research. As a result, 18% of patients were resistant to 1 or more antibiotics. Many cases of patients were resistant to multidrug-resistant drugs (resistant to 3 or more antibiotics). It is very difficult to find treatment drugs for children with antibiotic resistance. Treating multidrug-resistant patients is even more difficult, often having to accept drugs that can leave side effects in order to preserve the patient's life.

Most medical facilities today are facing the rapid spread of multi-antibiotic resistant bacteria with the number of drug-resistant bacteria and the level of resistance increasing. Doctor Ngo Nam Hai - Head of the Department of Intensive Care - Anti-Poison - Artificial Kidney, Vinh City General Hospital said: Previously, at the City General Hospital, there were very few drug-resistant bacteria, but now there are many drug-resistant bacteria. Bacteria are found in seriously ill patients. Many bacteria are resistant to all types of antibiotics, making it very difficult to cure...

Strengthening prevention and control work

Antibiotic resistance is a condition in which microorganisms such as bacteria, viruses, fungi, parasites, etc. are able to create a way to resist antibiotics, making it impossible for these drugs to kill or reduce their growth. The problem of bacterial resistance to drugs is a cumulative process, so if many types of drugs are used or used repeatedly, the level of drug resistance will increase. The more types of drugs are used, the more drugs the body will be resistant to. Therefore, when drugs are needed to kill bacteria or the treatment process will be more difficult the next time.

Antibiotic resistance is becoming increasingly dangerous to people's health. According to a WHO survey in Vietnam, 83% of Pneumococal bacteria (bacteria that cause pneumonia, meningitis, etc.) are resistant to penicillin antibiotics. Up to 72% of E. coli bacteria that cause diarrhea and intestinal diseases are resistant to ceftriaxone. If infected with these bacteria, previous generations of common antibiotics such as penicillin or ceftriaxone will no longer be effective. Vietnam is ranked among the countries with high rates of antibiotic resistance in the world.

To prevent this situation, on September 25, 2023, the Prime Minister issued Decision No. 1121/QD-TTg approving the National Strategy on Prevention and Control of Antimicrobial Resistance in Vietnam for the period 2023 - 2030, with a vision to 2045; with the goal of "slowing down the progression of drug resistance and preventing and controlling the spread of drug-resistant microorganisms and infectious diseases, while ensuring the availability and continuity of antimicrobial drugs and the rational use of antimicrobial drugs to effectively treat infectious diseases in humans and animals, contributing to protecting, caring for and improving human and animal health, protecting the environment and developing the country's economy and society".

The strategy sets out specific goals and targets by 2030, including: Raising awareness among local authorities and understanding among health workers, veterinarians and people about preventing and combating antibiotic resistance; strengthening the antibiotic resistance surveillance system to promptly warn about the emergence, spread, level and trend of antibiotic resistance in microorganisms; reducing the spread of microorganisms and infectious diseases; using antibiotics in humans and animals rationally, safely and responsibly... and by 2045, Vietnam will basically control antibiotic resistance, have an effective antibiotic resistance surveillance system, use and consumption equivalent to that of developed countries.

The strategy also sets out eight main tasks and solutions to prevent and combat drug resistance, including promoting inter-sectoral coordination of actions and responses; perfecting policies, laws, and professional regulations; promoting information, communication, and social mobilization; strengthening the system for monitoring drug resistance, use, and consumption of antimicrobials in humans, animals, the environment, and commerce; and strengthening human resources, finance, scientific research, and international cooperation to prevent and combat drug resistance.

There will be 3 key projects developed and implemented to implement the strategy. The Government has also clearly assigned responsibilities to ministries, ministerial-level agencies, government agencies and People's Committees of provinces and centrally run cities in organizing the implementation of the Strategy... At this time, Nghe An province is researching and developing a plan to implement this strategy.

Nghe An Health Department recommends: Each individual when using antibiotics should only take the medicine as prescribed by the doctor, do not arbitrarily buy and use antibiotics without consulting the treating doctor; when the doctor prescribes antibiotics, always take the full dose as prescribed, do not stop halfway, even if you feel much better. Do not use leftover antibiotics from previous use; do not share antibiotics in the prescription with others.