From common cold, body aches to diarrhoea, many people quickly rush to take one antibiotic or the other. Antibiotics are powerful medicines that fight bacterial infections. They can be life savers, but their misuse is best avoided.
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Avoiding medications, especially antibiotics, when pregnant appears to be the safest. In a study, researchers found that some antibiotics a pregnant woman takes can affect the unborn baby in several ways. They found a surprising link between certain antibiotics and birth defects.
The first large analysis of antibiotic use in pregnancy, for instance, found that mothers of babies with birth defects were more likely than mothers with healthy babies to report taking two types of antibiotics during pregnancy. These were sulfa and urinary germicides called nitrofurantoins.
Birth defects linked to sulfa drugs included rare brain and heart problems, and shortened limbs. Those linked to nitrofurantoins included heart problems and cleft palate. The drugs seemed to double or triple the risk, depending on the defect.
The study which appeared in the 2009 Archives of Paediatrics and Adolescent Medicine had looked at the use of six different classes of antibiotics.
Likewise, azithromycin, a widely used antibiotic for common infections was found to be deadly for adults with heart problems or are at risk for it.
Azithromycin or Zithromax is prescribed for all types of bacterial infections from ear infections, bronchitis, pneumonia to a sore throat. Though more expensive than other antibiotics, it is popular because it often can be taken for fewer days.
The study, published in the New England Journal of Medicine, found that its uses may increase the likelihood of sudden death, by possibly causing abnormal, potentially fatal heart rhythms.
Researchers found a 2.5 per cent greater risk of death from heart disease in the first five days of using Azithromycin other than using other antibiotics or no antibiotic at all.
In addition, the study indicated the antibiotic should also not be used in people with diabetes or a previous heart attack, and those who have undergone bypass surgery or have had stents implanted because it may have similar effects on them as well.
Patients studied were 50 years old on average and not hospitalised. Most had common ailments, including sinus infections and bronchitis. Those on Azithromycin were about as healthy as those on other antibiotics, making it unlikely that an underlying condition might explain the increased death risk.
They found that the risk of death while taking the drug was more than double that of patients on another antibiotic, amoxicillin, or those who took none. Also, the highest risks were in Azithromycin patients with existing heart problems.
The level of drug abuse, antibiotics inclusive, in Nigeria is very high. Unfortunately, if individuals are aware that antibiotics can harm them much more than help them if they have a growing infection, they will not ask the doctor to give them antibiotics.
Meanwhile, Professor Iruka Okeke, Head, Department of Pharmaceutical Microbiology, University of Ibadan, described antibiotics as societal drugs whose effect when misused can extend to others in the society, thus the need to guard its use.
“Individuals must only use antibiotics when they have an infection that can be cured by that antibiotic. Otherwise, you should not be using the antibiotic,” she declared.
Professor Okeke said that although antibiotics are cheap, safe and effective for treatment of infections, resistance is growing against all antibiotics, including newer and expensive ones, due to mutation.
She declared: “Resistance to older antibiotics like Ampicillin and tetracycline is about 90 per cent. It is as much as 30 per cent for newer antibiotics like cephalosporins that are used for severe infections.
“So, we are actually at a point where somebody will get an infection now that would have been curable 10 years ago but which today, there may be no cure.”
In addition, Mrs Helen Oduntan, Chairperson, Association of Lady Pharmacists, Oyo State, stated that it is better for people to be more cautious about abusing any medication, including antibiotics.
Much as people already taking Azithromycin would not be asked to stop its use without first consulting with their physicians, Mrs Oduntan assured that FDA has commenced investigating into the possibility of Azithromycin disrupting heart rhythms.
According to her “with such information that Azithromycin may increase chances for sudden deadly heart problems, it is better that people, especially those with heart problems or those predisposed to heart problem such as the diabetics, avoid the use of this antibiotic.”
But, there are antibiotics as there are some other classes of drugs that cannot be used in pregnancy because they have been shown to cause abnormalities.
Dr Adenike Bello, an obstetrician and gynaecologist at the University College Hospital (UCH), Ibadan, Oyo State, said as with all drugs, they should be prescribed and all drugs should be used with caution in pregnancy.
Even though many women assume that the first three months of pregnancy is the most critical period to avoid medications, she said that is not quite true, adding “The general blanket is that drugs are not safe in pregnancy; each drug is taken at the face of its own value.”
Dr Bello stated, “The first three months of pregnancy is when the organs are formed; so the defects that you can have can be absolute. Sometimes, it can be absolute enough that it causes miscarriage; but there are some that will affect all the way.
“Tetracycline, for instance, at no time in pregnancy is safe because what it affects is the enamel, the lining of the bone and the teeth. So, at any time in pregnancy that you use it, it can still cause an enamel malformation in that baby. And a baby born with a bone deformity or teeth deformity has been put at a poor start from the beginning.”
It’s been found that the drug can affect the unborn child in several ways. They can act directly on the baby causing damage or abnormal development leading to birth defects or death.
Meanwhile, when used in early pregnancy, many classes of common antibiotics have also been associated with an increased risk of miscarriage.
The study published in the Canadian Medical Association Journal looked at antibiotics exposure during early pregnancy only. They looked at data from the medical records of women from 15 to 45 years old in the Quebec Pregnancy Cohort between 1998 and 2009.
Generally, when a woman does not take antibiotics during pregnancy, her risk of a miscarriage is approximately six to seven per cent. In the study, women who took certain antibiotics in early pregnancy had an increased risk of nine to 10 per cent.
However, Professor Okeke said individuals can protect themselves from all infections, including those that have grown resistant to antibiotics, through vaccination, maintenance of good sanitation, drinking clean water and eating safe foods.
The don urged health professionals to only prescribe antibiotics after a laboratory test has indicated it is required, and the type of antibiotics that will be effective so as to stem the incidence of antibiotic resistance and the emergence of multidrug-resistant bacteria.
She stressed the need for increased public awareness on the appropriate use of antibiotics, adding that stopping the abuse of antibiotics should be a joint effort by all.
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