Antimicrobial Stewardship – what we all need to know

Antibiotics saves lives — but when they’re used too often or incorrectly, they can loose their power.

That’s where antimicrobial stewardship comes in: a coordinated effort to use antibiotics wisely and keep them working when they’re really needed.

Dr Kobie Grobler, Physician, and Nolene Fouche, Clinical Pharmacist at Mediclinic Cape Gate share some answers to common questions.

What is antimicrobial resistance?

When organisms change and become difficult to kill, which results in infections getting more difficult to treat. Thus, leading to longer hospital stays, more medical costs and higher risk of complications.

What is the difference between antibiotic, antiviral and antifungal medicine?

Antibiotics are used to treat infections caused by bacteria, whereas antivirals are for viruses and antifungal medicine is for fungal infections. And can’t be interchanged.

Why is Antimicrobial Resistance (AMR) called a “silent pandemic”

Because it grows slowly and often unnoticed, but its impact is massive and global.  Unlike COVID-19, AMR doesn’t make headlines daily, but it kills hundreds of thousands of people each year.

What are the main causes of AMR?

Skipping doses, not finishing prescribed courses, and using antibiotics when not needed all contribute.

Can antibiotics cure viral infections like colds or flu?

No. Viruses don’t respond to antibiotics.  Rest, fluids, and sometimes antivirals are needed instead, but never antibiotics.

Why can’t I keep leftover antibiotics for next time?

Because different infections need different antibiotics. Using the wrong antibiotic may not work, or you may not even have a bacterial infection.  Leftover antibiotics may be expired, be the wrong dose, or an incomplete course can make bacteria stronger and not weaker.

Why can’t I share my antibiotics with friends or family?

Because their infection may be caused by something completely different.  Sharing medicine is unsafe. It could delay the right treatment or cause resistance.

What are the dangers of taking antibiotics “just in case”?

It exposes bacteria to antibiotics unnecessarily, increasing the risk of resistance.  It also puts you at risk for side effects like diarrhea or allergies.

Can resistance spread from one person to another?

Yes. Resistant bacteria can spread through contact, contaminated food, or the environment.  This is why infection prevention measures in hospitals and communities are so important, such as handwashing.

Can natural remedies replace antibiotics?

No. Only antibiotics can treat bacterial infections.  Natural remedies may ease symptoms but won’t kill bacteria.

What is the “superbug” everyone talks about?

“Superbug” refers to bacteria resistant to several antibiotics, leaving only limited or expensive treatment options available.

Why do some infections require long antibiotic courses, and others short?

It depends on how deep-seated or severe the infection is.  Shorter courses can be safe for some infections, reducing resistance risks.

Can antibiotics be prescribed incorrectly?

Because many illnesses are viral, and antibiotics would not help. Waiting allows us to see if symptoms improve naturally.  Giving antibiotics too soon when not needed contributes to resistance and unnecessary side effects. The wrong type of antibiotic can also be prescribed for a bacteria, or at the wrong dose or for too long. 

What does “broad-spectrum and narrow-spectrum” antibiotic mean?

Broad-spectrum means the antibiotic works against many types of bacteria while narrow-spectrum targets more a specific group of bacteria.

Why are children and the elderly more vulnerable to resistant infections?

Their immune systems are either still developing or weakened.  They often need more medical care, which increases exposure to antibiotics.

Clinical pharmacist

What role does the public play in preventing Antimicrobial Resistance?

Never buy an antibiotic from an unauthorised provider because you think it will help you to feel better, you may get the wrong antibiotic and then you don’t get better and you drive resistance. Don’t pressure your healthcare provider to prescribe an antibiotic. Follow your healthcare provider’s instructions, to finish the full course of antibiotics as prescribed and never to share or use leftover antimicrobials.

What can a person do to prevent infections in the first place?

Good hygiene such as handwashing, safe food preparation, staying up to date with vaccinations.

How can the public support AMS?

Don’t demand antibiotics when a healthcare professional says they’re not needed.  Store and dispose of antibiotics properly—never flush or throw them in general waste.

Are new antibiotics being developed?

Some are, but the process is slow, costly, and not keeping pace with resistance.  The developments are also based on existing antibiotics and therefore bacteria are developing resistance against these new drugs at a very fast pace. That’s why protecting the antibiotics we already have is critical.

Can doctors prescribe antibiotics unnecessarily?

Yes, in a study of 2018 they found that 66% of GPs felt pressure from the public to prescribe antibiotics.

What is the most important message for families this week?

Antibiotics save lives, but only when used correctly.  Protect them by preventing infections and following medical advice.