The doctor will not pass – Newspaper Kommersant No. 8 (7453) dated 01/18/2023

More than 70% of Russians who have taken antibiotics in the past six months have done it wrong – either interrupted the course ahead of time, or self-medicated, for example, drank such drugs for a sore throat or as an infection prevention. This became clear in the course of a study by the Central Research Institute for the Organization and Informatization of Healthcare of the Ministry of Health (TsNIIOIZ), the results of which became known to Kommersant. Scientists warn that 43.1% of respondents are at risk of developing antibiotic resistance, that is, bacterial resistance to various antibiotics.

By order of the medical department, scientists from the Central Research Institute for Organization and Informatization of Healthcare of the Ministry of Health conducted a study of the level of knowledge, attitudes and behavior of Russian citizens “in the field of resistance to antimicrobial drugs.” The purpose of the work, specified in the report of the specialists, is to prevent the development of antibiotic resistance, to preserve the life and health of the country’s inhabitants.

The study, which was conducted in November last year, involved 2725 people (45.6% of men and 54.4% of women). It turned out that over the past 12 months, 54.6% of respondents (1489 people) have taken antibiotics. Of those taking drugs, about half (49.1%) were self-medicating.

The overwhelming majority of citizens bought antibiotics in a pharmacy without a prescription, although 65.5% knew that this was prohibited.

The likelihood of self-treatment decreased when respondents received information about antibacterial drugs from a doctor and increased if the respondent was guided only by his own experience.

At the same time, in 72.5% of cases (1080 people), the use of antibacterial drugs was irrational. This applies to antibiotics not prescribed by a doctor – for SARS, other viral infections, fever, cough, COVID-19, sore throat, flu, headache, diarrhea and for the prevention of infections. In addition, the respondents stopped the course prescribed by the doctor ahead of time.

Most often, among the reasons for not completing the course of taking the drugs, the respondents named improvement in the condition (73.9%), disagreement with the duration of the intake (8.8%), and the occurrence of adverse reactions (7.9%).

At the same time, almost all participants in the study (87.9%) knew that the frequent and incorrect use of antibacterial drugs reduces their effectiveness and is dangerous.

According to the experts of TsNIIOIZ, the respondents had the most complete information about the side effects and safety of taking antibacterial drugs. However, the majority of respondents believed that antibiotics kill viruses and are also effective in ARVI (colds) – 41.6%. In addition, more than half did not know that the incorrect use of antibacterial drugs causes a decrease in the effectiveness of treatment not only for themselves, but also for other people (60.5%).

The authors of the study conclude that, taking into account the use of antibacterial drugs not prescribed by a doctor, as well as in cases of interruption of the full course of antibiotics, 43.1% of respondents were at risk of developing antibiotic resistance.

Roman Kozlov, chief freelance microbiologist of the Russian Ministry of Health, notes that Russians have begun to use antibiotics more often (including uncontrolled) during the pandemic. In the first waves of the incidence of coronavirus, according to him, the consumption of antibiotics in the country increased by almost a third – by 28.4%, but “thanks to the efforts of the Ministry of Health and the professional community” by the end of 2021, it returned to “pre-pandemic” indicators. Specialists, Mr. Kozlov continues, explain the fascination with such drugs due to the lack of awareness of patients: “Some people still do not know that antibiotics only act on bacteria, so it is useless to take them in case of viral infections.” The irrational use of antibiotics, Mr. Kozlov supports the conclusions of the researchers, can lead to more serious problems – for example, resistance (or resistance) of microbes to an antibiotic.

Aleksey Moiseev, a pulmonologist at the Department of Occupational Pathology and Pulmonology, Clinical Hospital No. 3 of the Sechenov University of the Ministry of Health, confirms that in recent years, the impact on resistant microorganisms has become increasingly difficult, requires the use of alternative drugs or higher doses, and this makes the treatment more expensive and increases the risk of toxic effects. “Microorganisms that are resistant to several types of antibiotics are called multidrug-resistant or superbugs. Human-to-human transmission of resistant bacteria is increasing the prevalence of resistant infections, resulting in millions of deaths each year. Over the past decade, several strains of pathogenic microorganisms have formed that are sensitive only to single antibacterial drugs from the reserve group,” says Mr. Moiseev. He notes that antibiotic resistance is dangerous for all patients without exception, but first of all it concerns patients with immunodeficiencies, autoimmune diseases, patients with chronic lung diseases, patients receiving immunosuppression, cancer patients, as well as the elderly.

According to Roman Kozlov, antimicrobial drug-resistant (AMR) infections cause more than 700,000 deaths worldwide every year, of which more than 50,000 occur in the European Union. He cites expert estimates that by 2050 the burden of AMR will lead to losses for the global economy in the amount of $ 100 trillion, and the mortality from infections caused by microorganisms resistant to antimicrobials will be 10 million people – more than die from cancer today.

Yulia Fokina, a general practitioner and cardiologist at the Doctor Nearby medical company, confirms that in her practice she encounters cases of self-treatment with antibiotics, but the awareness of the population and the restriction on their sale, she believes, “are doing their job.”

Roszdravnadzor notes that the violation of prescription drugs, including antibiotics, refers to “gross violations of licensing requirements”, for which, in accordance with the Code of Administrative Offenses of the Russian Federation, administrative liability is provided.

“Roszdravnadzor calls on pharmacy organizations to strictly comply with the norms of the law regarding the distribution of prescription drugs, and citizens to be responsible for their health, not self-medicate and take medicines only as directed by a doctor,” Kommersant was told in the press service of the department.

Natalya Kostarnova

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