In the frame of MIMS highlights World Antimicrobial Awareness Week 2021 

Text written by Nóra Lehotai and Nabil Karah.

Nabil Karah is not only a physician and researcher, but also senior project advisor at the Norwegian Aid Committee (NORWAC, https://www.norwac.no/), residing in Oslo, Norway.In his connection with Umeå University, he is associated with Prof. Bernt Erik at the Department of Molecular Biology.

 

 

Antimicrobial awareness 

When Nabil hears antimicrobial awareness, he thinks about it at two levels:

“One level is at the health care providers, who prescribe antibiotics (ABs), and the other level is thegeneral public.”

Research on antibiotic resistance 

“My research is about finding out why bacteria areresistant to ABs. It is basic molecular research but we provide the data to people are working in public health, who then can convince other physicians and the public why AB resistance should be taken seriously. Several of our studies have highlighted the rate of AB resistance, pointing out how big problem this is.”

Nabil and his team can also show how easily bacteria exchange AB resistance genes.

“With time, bacteria will gain more resistance, becoming super bugs. We provide the data to others who are then able to argue with this proof against using too muchABs.”

Their publications are all withopen access, granting availability to everyone who is interested. 

Geographical difference among the protocols of prescribing antibiotics 

Nabil says that the use of ABsis very different depending on where you are in the world. He thinks that one approach is better than the other when it comes to fighting against AB resistance.

“The approach I favour is when everything happens according to rules: strong regulations - ABs are prescribed by doctors, you cannot buy them off shelf in the pharmacy or supermarket, people follow the instructions and the length of take is determined by guidelines, it is not up to the doctor; well-structured and centralized rules. This is true for Sweden, for example.”

He reveals that in other countries around the world, it is rather the opposite.

“The doctors decide the course of ABs based on their own judgement; you can just buy it in the pharmacy without prescription. Doctors can prescribe too high dose, too often without the real need.Misuse in agriculture and farming is another big part of the problem.  
In general, there is a huge overuse of ABs in big part of the world, concludes Nabil.”

 

Picture: Antibiotics. Credit: Mostphotos. 

 

Antibiotic resistance is a complex global problem 

Tackling AB resistance is a complex problem. Many organizations and people are spreading awareness and it is reaching people, however Nabil fears that:

“They will become overloaded and the topic loses its importance and seriousness. Take for example the COVID-19 pandemic and vaccines. Many people became resistant against accepting the vaccines because they thought that researchers and doctors wanted to scare them. They also heard about it so many times that they got used to it and it is not news anymore. Therefore, we need to do raising awareness in a smart way.”

We also need to be cautious and find a solution fitting the country, involving the local doctors, researchers, customized according to the local needs and resources.

“There is no “one fits all” solution. In my opinion, Sweden has a good general public awareness in this topic but there is place for improvements in agriculture and farming. Denmark has stricter rules for pigfarms, for example. You need to have clear facts and numbers to tell the people, convince doctors so they act accordingly when seeing patients and explain to them why they made this decision.”

Nabil tells that in Norway, they are producing lot of short movies and other sources of information in other languages than Norwegian and English.

“This is something that needs to be addressed. All groups of society need to have information available from the beginning.AB resistance is a global challenge, among others thus, it needs a global solution: open minds, welcome all nations.”

ABs are needed, they are the key in fighting infectious diseases, curing people.

“We need to do everything in our powerto keep the available ABs effective as long as possible. In order to achieve this, we must stop misusing them.”