Although inappropriate use of drugs by patients promotes antibiotic resistance, non-resistant strains are acquiring resilience through diverse modes, hence limiting options for effective treatment, medics have said.

The medics were speaking during a one-day workshop on antimicrobial resistance organised by the Rwanda Medical Association, GalaxoSmith Kline and Lancet Laboratories in Kigali at the weekend.

Dr Kayitesi Kayitenkore, the chairperson of Rwanda Medical Association, said resistance of microorganisms to antibiotics is increasing because of poor or limited diagnosis.

"Sometimes patients have viral infections but end up using antibiotics. In this case the drugs would totally be ineffective,” said Dr Kayitenkore.

She added that without continuous culture assessments in hospital setting, patients run out of drug options because sensitivity of microorganisms on the available drugs is not monitored.

"Doing culture tests before preparing the antibiotics provides appropriate guidance on treatment options and every time a review is necessary to assess whether the organism is responding to the drug or not,” she added.

Dr Kizito Kayumba, an epidemiologist from GlaxoSmithKline, a drug manufacturing company, said poor sanitary and cultural practices within communities expose people to resistant strains, hence aggravating the burden of importing drugs.

"Community acquired respiratory infections such as staphylococcus, pneumonia and tuberculosis can’t be treated without considering the element of resistance. Drugs to treat them are costly but once such infections are acquire, it only means importing more drugs,” Dr Kayumba said.

How infections become resistant

The first World Health Organisation report on antibiotic resistance, released two years ago, found that resistance to the treatment of last resort for a common intestinal bacteria, Klebsiella pneumoniae–carbapenem antibiotics and that urinary tract infections from resistant E-Coli were wide spread.

Also people with MRSA (methicillin-resistant staphylococcus aureus) were 64 per cent more likely to die than those with a non-resistant form of the infection.

However, Dr Ben Prinsloo, a pathologist from Lancet Laboratories in South Africa, blamed the increasing antimicrobial resistance in humans on the increased use of antibiotics along the food production chain.

"Animals spend most of their time being fed kilogrammes of antibiotics because farmers want them to achieve a certain degree of qualities. That is the meat we consume without considering that our bodies are accumulating drugs,” Dr Prinsloo explained.

He reiterated on that unnecessary post-surgery prescriptions of antibiotics should be avoided because they reduce sensitivity to drugs after available treatment options become expensive.

"It is a common practice for medics to administer antibiotics after surgery but this is wrong if the patient has no infection. Secondly, when treatment options for an antibiotic run out, a more expensive choice is sought,” he said.

Dr Prinsloo cited penicillin that used to be effective but that resistance grew over time and "now sometimes we may have to rely on more expensive drugs instead.”

Dr Ahmed Kalebi, a pathologist from Kenya, said the biggest bottleneck in controlling antibiotic resistance in Africa is poor coordination between doctors and laboratory technicians.

"Before you give an antibiotic, you must confirm whether that infection is able to respond. This depends on the way a doctor orders for tests. Even when you look at the tests for resistance, it is possible to get wrong results but that can be monitored by the doctors,” said Kalebi.

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