The impending antibiotics apocalypse in Nigerian Healthcare and the Malaria & Typhoid Diagnosis Debacle.

So, a patient came in with the test result of a Urine Microscopy/Culture/Sensitivity test, There was significant growth of a bacteria that was resistant to everything. I mean your Penicillins, Ceftriaxones, Ciprofloxacins, Azithromycins, Gentamicins, about 10 different antibiotics were tested, I just shipped the patient off to a Teaching Hospital. This is the 2nd time it's happening in 2 years.

This got me wondering. Why won't we have antibiotics resistance in our practice when they are as common as candy as is readily available to every Tom, Dick and Harry that wants one, without even presenting a prescription?

Just walk into any Pharmacy or Chemist (Chemists a.k.a Patent Medicine shops aren't even supposed to stock antibiotics to begin with) and ask for one, they'll gladly give you. You can buy any drug you want over the counter in Nigeria including Chemotherapy drugs (for treating cancer) which are supposed to be tightly controlled.

Antibiotics are so much abused to the extent that people don't even complete their dosage, They use 3 or 4 tablets and dump the rest. We all have unfinished packs of Ampiclox and Ciprofloxacin on our nightstands.
The Popular Ampiclox should be taken every 6 hours, people rarely do that.

I've seen people use antibiotics for a myriad of health issues that don't even need antibiotics for example

1) To clean the "system" after menstruation (as if your body is a V6 engine that needs oil change)

2) To clean the "system" after having unprotected sex ( I still don't know this system they keep referring to)

3) As emergency contraception after unprotected sex (Has Postinor and all his brothers finished in the pharmacy?)

4) For the almighty Nigerian "Toilet Infection" (Which is almost always vulvovaginal candidiasis, a fungal infection)

5) For a clean cut, injury or bruise.

6) For cold, cough and cattarh (Which is caused by a virus, unless it becomes cross infected with a bacteria, your actifeds and procolds and cough syrup would do the trick).

The Pharmacists who are supposed to be the gate keepers preventing us from the apocalypse instead of doing their jobs are busy trying to call themselves consultants and trying to close down pharmacies owned by doctors, Which brings me to the biggest abuse of antibiotics in our country.

7) The Malaria and Typhoid Diagnosis. Just walk in to any private or Primary/Secondary healthcare center and complain that you have Fever, body pain, bitter taste in the mouth, bla bla bla and mistakenly mention vomiting, abdominal pain and diarrhea, They'll instantly give you a diagnosis of Malaria and Typhoid which begs the question, since when did Vomiting, abdominal pain and diarrhea cease to be a symptom of Acute Malaria?

Check medscape and other medical literature if you feel I'm wrong. A prescription for antimalarials and Ciprofloxacin(an antibiotic) is given to cure the non-existent Typhoid.

It has gotten so bad that people now go to Pharmacies to buy Ciprofloxacin plus antimalarials whenever they have even the slightest symptom of Malaria because to them, it's Malaria and Typhoid.

I can't even begin to count how many times patients showed me a pack of Ciprofloxacin as the antimalarial that they are using. It is that bad.

To further solidify this charade, They'll ask for a Widal test which is the most useless test ever as far as I'm concerned, because a Single Widal test means absolutely nothing because anything that will give you a fever will give you a significant Widal titre including, you've guessed it, Malaria! A Widal test is done then repeated to check for Doubled titres in 10 to 14 days time to clinch the diagnosis, that is if the preferred diagnostic work up like Bone marrow and Blood culture aren't available.

I am not saying that cases of Genuine Typhoid enteritis don't exist, but it is not as common as some Doctors and healthcare workers would want to make you believe due to their quest to bill patients higher for Malaria treatment and justify the billing. It is unjust to subject every patient with a fever and vomiting to a Widal test to generate money for the facility.

A consultant gastroenterologist (people that specialize in diseases of the digestive system of which Typhoid is one of them) famously said that in his 30 years of practice, he has only seen 5 cases of Typhoid fever.

I think Doctors should not be in a haste to prescribe antibiotics and for Pharmacies and Patent medicine shops to be tightly controlled so that antibiotics are only sold to patients with a prescription.
If the trend continues like this, a time will come when all antibiotics will fail due to resistance just like it is gradually happening in America and common illnesses like Tonsillitis and the Real Typhoid fever will become major killers once again.

The mods finally unbanned this thread.
@Dominique, Sissy3 and Seun, let's educate the public.

complain of headache/fever and my mum will go buy antiboitics and Lumartem for you. I have packets of these drugs in my room untouched. and she won't listen o. she would tell u thaz what they would give u in d hospital. these old peoples, they would never listen. nothing you can tell them. they wld tell you i'm your mother, u are not wiser than me

cooncudee:
complain of headache/fever and my mum will go buy antiboitics and Lumartem for you. I have packets of these drugs in my room untouched. and she won't listen o. she would tell u thaz what they would give u in d hospital. these old peoples, they would never listen. nothing you can tell them. they wld tell you i'm your mother, u are not wiser than me

I feel you. It's the society we are in. You've not treated malaria till you add an antibiotic.