While there is increased resistance to Amoxicillin in some areas, it is ‘still working’ in the community, Claude Mambo Muvunyi, the Director General for Rwanda Biomedical Centre (RBC) told The New Times.
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Amoxicillin is a penicillin antibiotic that is used to treat bacterial infections, such as chest infections (including pneumonia) and dental abscesses. It can also be used together with other antibiotics and medicines to treat stomach ulcers.
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The explanation about the anti-microbial resistance follows reports by medical professionals saying that Amoxicillin efficacy has dropped by 80 per cent in some cases.
Muvunyi admitted that Amoxicillin has been used for so long and increased resistance to it is understandable.
"This efficacy reduction depends on the study conducted and setting including hospital care and outpatient care. It may be specific to one hospital for a given period of time,” he said, but noted that it is still working in the community.
"Amoxicillin is still working in patients from the community who have not been exposed to it or hospitalized in the past,” he explained.
How is prescription being handled?
He explained that Amoxicillin is not used for a single pathogen.
A pathogen is any microorganism, such as a bacterium, virus, fungus, or parasite that can cause disease in its host such as human beings.
"A certain pathogen can be resistant to it but many others are still sensitive to it. We have alternative options such as Amoxicillin-Clavulanic acid (a.k.a Augmentin) which is stronger and more effective. Also, we have other antibiotics in the same family as Amoxicillin which are effective,” he said.
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Muvunyi explained that doctors have antibiotic prescription guidelines.
"If they have a bacteriology lab, they can request for bacterial culture and an antibiogram (test to know what antibiotic is effective in the lab). In case the lab is not available, they can use guidelines for empirical treatment. Doctors have a range of antibiotics. If Amoxicillin is not working, they can prescribe others,” he noted.
He said the long-term plan is to strengthen antimicrobial stewardship programmes at different hospitals.
"We plan to increase the number of laboratories capable of doing bacteriology. Lastly, we need to educate the community on the proper use of antibiotics,” he said.
Dr. Leopold Bitunguhari, a medical researcher at the University Teaching Hospital of Kigali (CHUK), emphasized that improper use of medicines undermines their effectiveness.
"If patients do not follow medical advice or are given drugs that do not match the disease, the treatment fails,” he said, explaining that amoxicillin is reportedly ineffective in 80 percent of cases due to misuse.
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He called for the development of updated drug formulations and urged healthcare professionals to enhance prescription practices.
He also stressed the need for pharmacists to adhere strictly to ethical standards, avoiding the sale of un-prescribed medications.
Some pharmacies sell antibiotics without prescriptions, fail to verify the appropriateness of prescriptions, or provide insufficient guidance on proper drug use.