Stopping taking antibiotics before the prescribed days from the doctor because we feel better. Taking them without a prescription. Forgetting to take them and thinking it doesn’t matter. Habitual behaviors with terrifying consequences. All these behaviors are like bringing infection-causing bacteria to the gym. They get stronger, immune to antibiotics, so that infections currently curable with a few days of medication will no longer be curable in a few years. In other words, they will be lethal. This is what Javier Segura, microbiologist at the Can Misses Hospital, assures on the occasion of November 18th, which commemorates the European Antibiotic Awareness Day (also the International Day of Islamic Art). Avoiding superbug infections being the leading cause of death in the world by 2050 has three pillars: rational prescription of antibiotics by healthcare professionals, development of new generations of these drugs by pharmaceutical companies and, above all, proper use by the population.

What is prudent use of antibiotics?

Well, use them when it is the right time and do not use them when it is not the right time. Do not use them when there is a viral infection or there is no high suspicion of a bacterial infection.

Is it difficult for people to understand?

Yes, it is very complicated because antibiotics are one of the few drugs that cure diseases. The drugs for diabetes or hypertension, for example, what they do is keep those ailments at bay, but they do not cure it. Antibiotics do. They are so good that we have turned them into a one-size-fits-all drug and that has led to other serious problems.

There used to be a difference between viral and bacterial infections.

Well, this has to be assessed clinically. The important thing is that no one takes the initiative to take any medication, and even less so antibiotics, without a medical evaluation, without tests. People in the street without training cannot decide to take antibiotics because they cannot distinguish a viral infection from a bacterial one. This leads to antibiotic resistance and makes managing infections more complicated on a global level.

Why is an antibiotic not useful for a virus?

Antibiotics are molecules specifically designed to kill bacteria. They do nothing for viruses. There are other drugs, antivirals, that are for viruses. In the same way that for fungi there are the antifungals. You have to prescribe the right drug based on what you suspect the patient has.

What is the consequence of taking antibiotics on our own?

Well, all this misuse of antibiotics that we have been doing for years and that we may be doing at present means that we have a catastrophic outlook: the most solid studies say that in 2050 the main cause of mortality in the world will be infections caused by multiresistant bacteria, what we know as superbugs. By taking antibiotics unnecessarily or taking them wrongly, we encourage these superbugs to predominate. This catastrophic future can be reversed with proper use of antibiotics, which is why it is so important to be aware. It is in our hands to avoid that in 2050 the major cause of mortality will be these superbug infections.

There are already countries with serious problems in this regard.

Yes, but it is not a problem for just some countries, it is something global, what we call a silent pandemic because it is something that the people in the street do not see. It is a growing problem. In the hospital we have a package of measures, among them the PROA group (Program for Optimization of Antimicrobial Use), made up of multidisciplinary teams: Pharmacy, Internal Medicine, ICU, Microbiology and infection control nurses. Now teams are also being formed to promote this good use also in Primary Care. In the hospital, when there are very complicated infections, such as sepsis or caused by superbugs, we adapt the antibiotic. This is also done in primary care. That is what we can do here, but then each person at home, individually, must apply his or her own measures. Taking antibiotics only with a clear indication from a physician will prevent us from reaching the disastrous situation of 2050. More than a catastrophic message, it is a message that by doing things right, by raising awareness, we can avoid this pandemic of multiresistant bacteria.

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