A lady regularly buys and takes various antibiotics whenever she fell ill. She also gives antibiotics to her children and other relatives when they complain of any ailment. This, she does without a doctor’s prescription.

However, when she fell seriously ill and was later diagnosed with pneumonia at the hospital, doctors discovered she was resistant to the antibiotics prescribed for her. She experienced delay in recovery and more expenses. She experienced what medics call antibiotics resistance.

According to the World Health Organisation (WHO), antibiotics are medicines used to prevent and treat bacterial infections.

“Antibiotic resistance occurs when bacteria changes in response to the use of these medicines. Bacteria, not humans or animals, become antibiotic-resistant. These bacteria may infect humans and animals, and the infections they cause are harder to treat than those caused by non-resistant bacteria,” it said.

WHO says antibiotic resistance leads to higher medical costs, prolonged hospital stays, and increased mortality.

A growing list of infections — such as pneumonia, tuberculosis, blood poisoning, gonorrhoea, and foodborne diseases — are becoming harder, and sometimes impossible to treat as antibiotics become less effective, it said.

“Where antibiotics can be bought for human or animal use without a prescription, the emergence and spread of resistance are made worse. Similarly, in countries without standard treatment guidelines, antibiotics are often over-prescribed by health workers and veterinarians and over-used by the public,” WHO said.

Pharmacist Kenneth Ede Ujah, said antibiotics are ‘prescription only medicine’, meaning it requires the prescription of a certified professional.

“So, they are actually ‘prescription medicines’ and should not be purchased or used over the counter unless on the recommendation of a medical practitioner.”               

He said health care professionals that could be a physician, a registered nurse who will recommend the antibacterial or antibiotic after checking and finding out that “this anti-bacteria or antibiotics will be beneficial to the client/patient for that bacterial infection.”

 “Also, antibiotics are not completely free from side effects. Because of that, you must take antibiotics under a prescription, so that even when there is a drug reaction or side effect because the drug is properly recommended, you can go back to whoever gave that prescription and the person will do a medical review to see if that thing you are complaining of is from the use of the antibiotics or not, then give proper advice or recommendation for the benefit of your health.

“Do not take antibiotics without prescription, do not go and buy antibiotics for yourself because maybe your friend has used it or because a neighbour used it and she got well, so she now recommended it for you to go and use. It is dangerous to your health. It is fatal. It can kill, so do not use.”

He said, “That is a major problem. It is not that the law is not there but we are just not implementing the law. We are not enforcing it. It is everybody’s duty – the man going to buy shouldn’t go and buy without a prescription and the pharmacist who is selling shouldn’t sell without a prescription – if we all work in that way we can bring the issue of anti-microbial resistance to a stop.

“There are other issues like the use of antibiotics in animal production, poultry etc. The veterinary group should also get involved. There are rules on certain things like when you treat large poultry for example with drugs you don’t sell it immediately; you allow that drug to go. Until we address those issues, anti-microbial resistance will always be a major problem in our country.”

Recently, the National Agency for Food and Drug Administration and Control (NAFDAC) warned Nigerians against abusing antibiotics. 

Speaking during the 2021 World Antimicrobial Awareness Week (WAAW), Director General of the agency, Professor Mojisola Adeyeye, said there was an increasing rate of antibiotics abuse among the populace, adding that this has accelerated the process of Antimicrobial Resistance (AMR).

“The emergence and spread of drug-resistant pathogens continue to weaken the health systems,’’ she said.

A Public Health Expert at the Institute of Human Virology Nigeria (IHVN), Dr Temitope Adetiba, called for legislation to regulate the use of antibiotics in the country.

Dr Adetiba, said, “the world is facing a scary future of antimicrobial resistance where the bacteria that we are exposed to are becoming resistant to the antibiotics we have.”

He lamented that many people use antibiotics like they use pain killers. “In our setting, we have a high burden of different infections where antibiotics are required and we have a proliferation of antibiotics. 

“You can practically walk into any store in Nigeria where medicines are sold and buy antibiotics without a doctor’s prescription. Most times, you are either using the wrong antibiotic or you are using inadequate doses of the antibiotics, which makes the bacteria to develop resistance to the antibiotics.”

He added that legislation at both national and state assemblies will limit access to antibiotics, thereby guiding its use, and mandating people sick with infectious diseases to get tested.

He explained that failure to immediately treat tuberculosis with the specified dose of antibiotics and right duration also leads to drug-resistant tuberculosis.

The public health expert urged Nigeria to emulate countries where tuberculosis has been eliminated. There, “once the diagnosis of drug-resistant tuberculosis is made, it is immediately reported to local health authorities and not treated as an individual problem. Personal rights should not supersede overall public health.”

He urged the public to fight antimicrobial resistance by avoiding indiscriminate use of antibiotics to treat cough without testing for tuberculosis.

Does Nigeria have more female genital mutilation cases than other countries?

Nigeria has one of the highest rates of female genital mutilation (FGM), a national daily reported the country’s Minister for Women Affairs, Pauline Tallen, as saying.

Punch said Tallen was speaking in October 2021 at an event to raise awareness about FGM and cancer in the capital, Abuja, where she said government would “abolish harmful traditional practices” against women.  

Tallen further reportedly said: “In spite of government and partners’ positive interventions, high and community-level advocacy, capacity building of circumcisers, including the provision of alternate income for circumcisers, FGM practice persists in our society.”

More education through advocacy on the health danger posed on girls and women by the practice of FGM is needed, the minister said.