The WHO has declared antimicrobial resistance to be one of the top 10 public health threats. Arcsa promotes non-self-medication campaign.
Self-medication, easy access to drugs without a prescription, incorrect doses and not completing the recommended treatments are the main causes of drug resistance, a problem that can cause the next pandemic, according to the World Health Organization (WHO ), and that the authorities in Ecuador seek to avoid.
The sale of drugs without medical supervision to treat any symptoms triggers the mutation of pathogens, which makes it difficult to treat infections and increases the risks of spreading in all its variants, says a WHO report.
The entity shows alarming figures on drug resistance in a sample of 500,000 people from 22 countries around the world, caused by the deliberate or incorrect use of antibiotics, which instead of eliminating viruses or bacteria make them resistant and cause a therapeutic failure against the virus or bacteria causing the infection.
Faced with this alert, the Agency for Health Regulation, Control and Surveillance (Arcsa) urges the pharmaceutical industry to refrain from recommending an additional line of treatment that may alter the active compound in a medical prescription; and also calls on Ecuadorians to avoid self-medicating when the side effects that a drug could have on the body are unknown.
Doctor Javier Flores says that Arcsa’s request is correct. “From the point of view of Public Health, it is incorrect and irresponsible to allow the purchase of drugs, especially antibiotics, without a prescription,” he says.
According to Arcsa, it has become normalized among the population to “recycle” medical prescriptions among family and friends, often due to ignorance; For this reason, it warns that the risk of self-medication or changing the drug specified in the prescription are risks that do not have immediate consequences, but do have long-term consequences, especially if the patient requires drug treatment for which they have acquired resistance.
The pharmaceutical industry points out that, even before the exhortation of the regulatory agency, there were already internal campaigns to respect the prescription.
Christian Coll Baquerizo, manager of the Difare Group Pharmacies Division, which has 4,500 points of sale nationwide, between Pharmacys and the Cruz Azul and Community Pharmacies franchises, points out: “Since 2016, we have implemented the internal campaign ‘La prescription is respected ‘, addressed to our staff in all pharmacies ”.
Thus, he assures, has been “reinforcing the message that, if a client approaches with his prescription, we must give him the same medications prescribed by his doctor, since the medications have components that can generate complications due to misuse, and that is The key is to consume them responsibly, and always with the guidance of a specialist ”.
And it makes a differentiation: “Within the supply of medicines, there are over-the-counter products, also known as OTC; these products prevent and relieve patient discomfort until they can go to their trusted doctor ”. It is what can be sold freely, or so it should be.
Santiago Salguero, executive director of the Association of Pharmaceutical Laboratories (Alafar), maintains that “respecting the medical prescription is important, because it represents a point of contact between the doctor and the patient, through which the health professional indicates the exact consumption of medicines in order to achieve the recovery of the patient’s health ”.
But if that is not respected by the patient himself, then he will create resistance. Enrique Terán, a professor at the San Francisco de Quito University and Ph.D. in Pharmacology, has also observed errors in doctors at the time of prescribing.
“The custom of calculating the dose (of antibiotics) per kilo of weight has been lost. We have entered a massification process and the treatment has been standardized, that is, they give every patient the same dose, whether fat or skinny, and this is a great mistake, “said the doctor about a report in this medium about the excessive use of antibiotics in Ecuador.
Bacteria become more aggressive and an even more aggressive agent (antibiotic) must be sought in order to treat a patient; but the higher the level of aggressiveness of the antibacterial, the more damage can be caused to the individualTeran explains. That is why the WHO asks to strengthen controls. Also, the most aggressive antibiotics are in short supply and therefore cost much more.
Of the total Ecuadorian pharmaceutical market, the participation of over-the-counter products represents 25%; and in Difare and its chains, for example, this percentage is similar, says the company.
Antimicrobial resistance not only causes death and disability, it prolongs illness and this translates into longer hospital stays, the need for more expensive drugs and financial difficulties for those affected, says a United Nations (UN) report. .
According to Arcsa, constant visits are made to pharmaceutical establishments in the country to review the pharmacy prescription file and verify that each drug sold has its backup prescription.
But despite these recommendations and controls, it is still common to see people in pharmacies asking for antibiotics when they have a cold, which is caused by a virus. Even apothecaries have said they end up insulted when they tell clients that they don’t need this type of medication. “It’s my body, I know what makes me good,” says a clerk told by a woman earlier this week.
Other apothecaries do not make a problem and dispatch what clients request verbally, written on a piece of paper or even guided by WhatsApp images. “This cream did good for my cousin, give me the same one,” said a man while the apothecary counted the grievances he sometimes receives.
Why did we get to this point?
The doctor Javier Flores attributes this to the lack of professionals available for the number of inhabitants, which slows down care that must be timely. On the other hand, there is the patient’s own “initiative”, who, not wanting to wait long hours for medical attention, chooses to ask an inexperienced third party who had similar symptoms and copies the prescription hoping to feel better.
He also notes the interest of certain pharmacists that this continues, “since in an irresponsible way and in search of their own interests, sellers ‘recommend’ drugs without having health professionals to look after their own interests.”
The problem is that, because of their compounds, some painkillers are over-the-counter and others are not, says an apothecary, who acknowledges that, in practice, they do not observe much if the drug they sell must be prescribed.
The Organic Health Law establishes that the sale of medicines requires a prescription from professionals authorized to do so, with the exception of over-the-counter medicines.
According to the latest Arcsa registry, in Ecuador only 502 products are part of a list of over-the-counter drugs. Likewise, the institution has a base of anti-flu and cough medications that can only be sold under medical prescription. There are 159 products, including soft capsules, powders to dissolve in water and syrups; but all of them, in a brief survey carried out by this medium, are sold without a prescription.
To alleviate the problem of self-medication, Flores suggests empowering more health professionals and making the prescription mandatory for more medications that require it. “In case we don’t do this, we are doomed to extinction. When it is not the coronavirus that haunts us, it will be a multi-resistant bacterium “. (I)
Paul is a talented author and journalist with a passion for entertainment and general news. He currently works as a writer at the 247 News Agency, where he has established herself as a respected voice in the industry.
