Of late, it has become almost fashionable to swallow septrin, erythromycin, tetracycline, ampiclox, fragyl and other antibiotics whenever one gets a headache, abdominal pains and fever, among other conditions, without consulting the doctor. And although it is illegal to access drugs from a pharmacy without proper prescription from a physician, many ‘self-medicators’ somehow still get hold of these drugs, particularly antibiotics.

Dr Osee Sebatunzi, the Director of Kibagabaga Hospital, however, warns that this kind self-medication is wrong because misuse of antibiotics is the major cause of crippling infections today.

According to Sebatunzi, when some people experience symptoms such as minor cough and stomach pains, among others, they immediately rush to purchase antibiotics.

"Most times, these symptoms are just signals and are not necessarily the infection, they are clues to the disease which has to be identified through proper medication examination,” Sebatunzi says.

Common symptoms such as cough could be signs of many other infections such as allergies, hypertension, diabetes, pertussis or tuberculosis, hence immediate antibiotic exposure just stifles recovery, according to Sebatunzi.

"After experiencing these symptoms, reaching out for an antibiotic that is not medically recommended just increases the chances of ruining your health with wrong drug combination,” he explains.

While antibiotics are medicines used to treat infections caused by bacteria such as pneumonia, whooping cough, urinary tract infections, skin infections and infected wounds, doctors only choose an antibiotic depending on the bacteria that has caused a particular infection since sensitivity of bacteria towards antibiotics differs.

Dr Leo Ngeruka, a surgeon at Rwanda Military Hospital-Kanombe, warns about self-medication with antibiotics saying that because the person is unsure about the dosage, they risk among many things an overdose or under dose.

"Only medical practitioners know to what tune they are supposed to prescribe a drug. If you take these drugs without the right prescription, you risk overdosing yourself, or worse still, death,” Dr Ngeruka says.

The rise of drug resistant microorganisms

Research conducted on misuse of medicine reveals that the majority of drug resistant bacteria strains have evolved from poor usage of antibiotics.

For example, it is estimated that people with methicillin resistant staphylococcus aureus (food poisoning microorganism) die at a rate of 64 per cent than those without resistance.

Worse still, antibiotic abuse as a form of poor medical adherence is majorly responsible for the rise of multi drug infections such as tuberculosis (MDR-TB) which is estimated to be in 480, 000 people globally, according to the world Health Organization in 2013.

Nevertheless, according to Mayo Clinic, when penicillin and other antibiotics were first introduced, people perceived them as wonder drugs because they worked quickly and resulted into relatively few side effects. Most people mistakenly thought they were an answer to all common illnesses, eventually giving rise to drug resistance, among others.

Mayo Clinic, therefore, insists that taking antibiotics when they’re not the appropriate treatment promotes antibiotic resistance because antibiotics treat bacterial infections but not viral infections.

For example, an antibiotic is an appropriate treatment for strep throat, which is caused by the bacterium Streptococcus pyogenes. However, it may not be the right treatment for most sore throats which are caused by viruses.

If you take an antibiotic when you actually have a viral infection, the antibiotic still attacks bacteria in your body — bacteria that are either beneficial or at least not causing disease. And this misdirected treatment can then promote antibiotic-resistant properties in harmless bacteria that can be shared with other bacteria.

Broad spectrum and narrow spectrum antibiotics

Usually, antibiotics work by blocking vital processes in bacterial cells, killing the bacteria, or stopping them from multiplying which, in the end, helps the body’s natural immune system to fight the infection.

Dr Rachna Pande, a specialist of Internal Medicine at Ruhengeri Hospital, points out that there are mainly two categories of antibiotics, the narrow spectrum antibiotics which act on a limited number of germs (either gram positive or gram negative) and those that work broadly, known as broad spectrum.

"For example, Norfloxacin acts only on gram negative germs whereas broad spectrum antibiotic, such as cefatrioxone, act on a wide range of germs that are gram positive and negative,” Pande explains.

She adds that besides mutations that eventually contribute to resistance, abusing antibiotics causes most features of the disease to become masked.

"Taking antibiotics immediately the symptoms show up conceals the real condition and delays real diagnosis, thus making the treatment definitive,” she adds.

Dr Ngeruka warns people who abuse antibiotics.

"Misuse of drugs is a danger and expired drugs need not to be used or kept at home at all, unless there are medical circumstances allowing the provisions,” Ngeruka warns.

What do you do when you feel unwell?

Jacques Sindayigaya, a motorcycle taxi operator in Kigali

I am not into the habit of self-medicating, thank God I rarely get sick. Normally, when I feel unwell, I drink water and the pain reduces. I think one should see a doctor if the situation worsens.

Fabrice Nyirumuringa, S.4 student at College ADEC Ruhanga

I don’t remember when I last took medicine or went to hospital. Whenever I fall sick, I pray to God and, in most cases, I get cured. I can only go to hospital as the last option. However, self-medication is bad.

Fred Ndahiro, employee at at Star Times

I decide what drug to take depending on what I am suffering from. If it is a headache or pain in the joints, I use panadol or visit a pharmacy and explain to them how I am feeling then they help me. If the problem persists, I go to the hospital.

Isa Dushimire, a technician in Kigali

I always go to hospital if I’m not feeling well, I don’t like taking risks. I only take drugs that have been prescibed by the doctor. On some occasions, however, I have chosen to stay home and relax in order to let the body and mind relax and it has worked.

Yvette Uwineza, a student at University of Rwanda

Usually I visit the doctor whenever I feel unwell to avoid problems. However, I keep some painkillers at home just in case I get sick at night when I cannot readily access medical attention.

Kenny Mpayana, surveyor in Kigali

I only take medicine if I am sure about what I am suffering from. Conditions such as headache can be relieved by painkillers so there is no need to rush to the hosipital. I only go to hospital if the pain becomes severe.