Non-Prescription Drug Use: Development of Antimicrobial Resistance

Antimicrobial resistance (AMR) is becoming a major global threat in all countries due to the excessive and unregulated use of antibiotics. 1 In 2019, there were 4.95 million deaths worldwide due to AMR, of which 1.27 million were associated with AMR. 2 Additionally, uncontrolled and unscientific use of antimicrobials in livestock contributes to the emegence of resistant pathogens. 3AMR means that microorganisms causing bacterial, viral, fungal, and parasitic infections have developed resistance and cannot be killed by the drugs meant to treat these infections. 3Due to the emergence of drug-resistant pathogens and difficulties in treating widespread bacterial infections, vital procedures such as surgery, organ transplantation, and cancer treatments, etc. are also becoming increasingly risky. 2 Additionally, the coronavirus disease-2019 (COVID-19) pandemic has contributed to the silent spread of AMR recently due to the widespread overuse of antibiotics for severe and hospitalized patients. 4The World Health Organisation (WHO) reported that only 8% of hospitalized COVID-19 patients required antibiotic treatment due to bacterial co-infection while, 75% of the remaining were treated to prevent possible bacterial co-infections, leading to unnecessary antibiotic use.Between 2020 and 2022, the rate of antibiotic consumption rose from 33% to 83%, especially in the Eastern Mediterranean and the African regions, while decreasing in Europe and the Americas over time. 4,5e WHO's Global Antimicrobial Resistance Surveillance Report revealed AMR mainly in Escherichia coli, Klebsiella pneumoniae, Salmonella spp., Acinetobacter spp., Staphylococcus aureus, Neisseria gonorrhea, and Streptococcus pneumoniae, in regions of Africa, the Americas, South East Asian, European, Eastern Mediterranean, Antimicrobial resistance (AMR) is becoming a major health problem worldwide.Different factors contribute to the emergence of resistance, including excessive and inappropriate use of antibiotics.Non-prescribered antibiotic use is still widespread and contributes to antibiotic resistance.This study presents the development of drug resistance in a woman with recurrent urinary tract infection, highlighting the role of antibiotics taken without a prescription and emphasizing the importance of culture and antibiotic susceptibility tests in the success of treatment.In this case, inappropriate use of antibiotics triggered AMR, and consequently, the treatment has failed.An effective medication management system is necessary to monitor non-prescription antibiotic use in North Cyprus.Raising public awareness through education programs can reduce inappropriate and excessive antibiotic use.The development of resistance to commonly used antibiotics also reveals the need to develop new treatment strategies in the country.