Drug resistance: Patients with infections no longer responding to treatment, say experts

Lara Adejoro, Abuja

Medical experts have raised the alarm that the challenge of antimicrobial resistance is taking a toll on patients and healthcare delivery in Nigeria.

AMR occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness, and death, according to the World Health Organisation. As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.

Antimicrobials – including antibiotics, antivirals, antifungals, and antiparasitics – are medicines used to prevent and treat infections in humans, animals, and plants. Microorganisms that develop antimicrobial resistance are sometimes referred to as superbugs.

The UN body estimates that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths.

The World Bank estimates that AMR could result in $1tn additional healthcare costs by 2050 and $ 1tn to $3.4tn gross domestic product losses per year by 2030.

A recent report by the Africa Centres for Disease Control and Prevention said the likelihood of falling ill or dying from diseases that resist treatment has escalated in Africa, with children and other vulnerable groups being most at risk.

“The continent faces the highest mortality rate from antimicrobial resistance, with 27.3 deaths per 100,000—exceeding the combined death toll from HIV-AIDS, tuberculosis, and malaria,” the report showed.

The report revealed that Africa bears a significant burden of infectious diseases, accounting for approximately 95 per cent of malaria deaths, 70 per cent of people living with HIV, and 25 per cent of TB deaths globally.

A Medical Virologist and Immunologist at the Adeleke University, Ede, Osun State, Dr. Oladipo Kolawole said is increasingly burdening healthcare systems worldwide.

Kolawole noted that AMR leads to ineffective treatments, prolonged illness, higher healthcare costs, and a greater risk of severe outcomes or death.

“This has increased healthcare costs: Treating drug-resistant infections is more expensive. Patients often require longer hospital stays, more intensive care, and the use of last-resort or newer, more expensive antibiotics. AMR is associated with a higher risk of complications and mortality. Infections that were once easily treatable, such as pneumonia, tuberculosis, and sepsis, are now becoming life-threatening due to resistance.

“Also, resistant pathogens can spread within communities and healthcare settings, leading to outbreaks that are difficult to control and require significant public health resources. AMR threatens the effectiveness of surgeries, cancer therapies, and organ transplants. These procedures rely on effective antibiotics to prevent and treat infections, but with increasing resistance, their safety and success rates are compromised.

“AMR could roll back decades of progress in medicine. The ability to treat infections is fundamental to many aspects of healthcare, and rising resistance undermines this foundation. In addition, AMR does not recognize borders, making it a global health challenge that requires coordinated international efforts to address through surveillance, research, and new treatments,” he explained.

The virologist said AMR is a major healthcare challenge, necessitating urgent action to develop new treatments, improve antibiotic stewardship, and enhance global health infrastructure to manage and mitigate its impact.

Also, a professor of Public Health at the University of Ilorin and former National Chairman, the Association of Public Health Physicians of Nigeria, Tanimola Akande, emphasised that AMR is the development of resistance by microbes to antibiotics meant to destroy them in the body system.

He said that with resistance, the microbes are not destroyed even when the particular antibiotics they developed resistance to are used.

“This will lead to symptoms and signs of the illness remaining unabated and even can lead to death. It can prolong hospital stay and duration of treatment with antibiotics, which attracts direct and indirect costs to patients.

“When AMR occurs to a particular antibiotic, it means a stronger antibiotic has to be used or a combination of antibiotics to kill the microbes. Such antibiotics are usually costlier. Newer antibiotics have to be produced when older ones are no longer effective and they are very expensive,” Akande stressed.

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