LOCAL doctors are urging Jamaicans to educate themselves about antibiotic resistance in order to lessen the impact that a “superbug” may have, were it to reach our shores.

This call comes after citizens reacted with shock earlier this month when the World Health Organization (WHO) expressed concern about a gonorrhoea “superbug” that three patients in the USA presented with, which has also been identified in a few cases in Japan.

“It’s only a matter of time, yes, unless there’s a breakthrough,” said Dr Alison Nicholson, lecturer in the Department of Microbiology at The University of the West Indies, and research team member for the National Action Plan Against Antimicrobial Resistance.

“We have a tourist industry. That’s why the WHO is worried and have a mantra that resistant anywhere is resistance everywhere — meaning you have to control it all over. So you can’t try to control the gonorrhoea superbug in the USA alone, because people can hop on a plane and go elsewhere,“ she explained in an interview with the Jamaica Observer. “It also doesn’t have to be gonorrhoea, it can be something airborne. You have to take it out on a wide scale, hence the (need for the) National Action Plan Against Antimicrobial Resistance.”

But why the emphasis on antibiotic resistance?

Dr Nicholson explained that conditions like gonorrhoea and many other illnesses are treated with antibiotics, and if the medication is not taken properly, the disease will develop resistance and may become untreatable.

“If the disease is treated properly the organism is killed, dead and done. Whatever you do, make sure you kill the organism so you don’t have any left behind. That’s why, while in private practice, whenever a patient came to me with gonorrhoea or something requiring antibiotics, I would give an injection as I didn’t trust them to take the entire course of antibiotics. People tend to stop taking them when they feel better and pass some to a friend, and that’s how you get the resistance, because you didn’t finish the course of tablets which would have completely killed the organism. Now some is left behind and resistance develops,” she explained.

However, this trend is not new and experts explained that one of the first superbugs was Methicillin-resistant Staphylococcus aureus (MRSA), which used to be easily treated but gradually became resistant to methicilin — the antibiotic used to treat it — hence the label superbug.

“Superbug is a term used to refer to any organism resistant to a wide range of antibiotics, so it’s not something to be fearful of. People are in shock because Neisseria gonorrhoeae has become resistant to many of the antibiotics, and there are serious complications that can result. But gonorrhoea isn’t the only bug that has developed resistance or can develop resistance,” Dr Nicholson said.

Luckily for Jamaica, despite the global trends, Dr Nicholson pointed out that the country has maintained a low resistance rate to antibiotics of 3.2 per cent, compared to rates of 50, 60, and 70 per cent in other parts of the world.

In the meantime, she appealed to medical doctors to pay more attention to educating themselves and patients about antibiotic resistance.

“Continuing medical education is not an option for a doctor. If you do not take advantage of the local and some of the international conferences, then you are going to become irrelevant. You have to continue your medical education and there are certainly opportunities for that,” she said.

“We have to also change how we teach medical students. We are now telling them about antibiotic resistance, as when they go out to practise it’s a different set of challenges. You have to tell them the complicated parts of it as it’s a complicated system they are going there to face,” she added.

Senior medical officer at Savanna-la-Mar Public General Hospital Dr Alfred Dawes has endorsed the National Action Plan Against Antimicrobial Resistance, which is expected to be available by or before WHO World Antibiotic Awareness Week in November.

“Bacteria that are multi-resistant are spreading across borders easier. In addition, we are developing our own Jamaican multi-drug resistant bugs because of the overuse of antibiotics. Already, the multi-drug resistant bacteria that we have here are costing us hundreds of thousands of dollars for the course of high-powered antibiotics needed to treat one patient. The patients stay longer in ICU (intensive care unit) where we already have a space challenge, and because they have to be isolated it puts an additional strain on supplies and human resources.

”We need local and national policies to guide antibiotic use to prevent this from happening. At Sav (Savanna-la-Mar hospital), we are looking at the types of bacteria causing infections and which antibiotics are most effective at killing them, as well as which ones to which they have resistance. We can then develop a hospital-specific policy on antibiotic use,” he said.