AVOIDING DRUG RESISTANCE AND TREATMENT FAILURES

AVOIDING DRUG RESISTANCE AND TREATMENT FAILURES
Some germs can so get used to a drug that the drug when ever it is introduced will not be able to kill those germs that have developed such resistance to it. Initially, the drugs were able to kill the germs. One of the reasons for drug resistance is exposing micro organisms to inadequate quantity of the drug. When people started taking a lower dosage of chloroquine than what was recommended the malaria parasites developed resistance to it. Chloroquine is no longer used for malaria treatment in all the places where such resistances exist. Due to inadequate intake of recommended drug regimen malaria parasites have developed resistance to common drugs used to kill them. That is why the World Health Organization (WHO) recommends combination therapy for malaria treatment. Most physicians combine fansidar or camoquine with an artemisinine product like artesunate and add quinine hydrochloride to it. Single drug treatment of malaria is no longer recommended because of wide spread drug resistance.
The frequent abuse of malaria drugs by people who generally under treat it occasioned the emergence of resistance of malaria parasites to common malaria medications.
Artemisinine drugs should be given for at least six days with a loading dose on the first day of treatment. Health care providers should ensure that in treating malaria the full course of treatment is given to prevent resistance to drugs.
The same advice goes for antibiotics, used for the treatment of infections. Salmonella the organism that causes typhoid and paratyphoid infections is commonly treated with amoxicillin or ciproxin. Because of abuse of these drugs by patients who take less than adequate quantities of the drug, salmonella in many places have developed resistance to these drugs. Drug companies who manufacture drugs with less quantity
of the drug than what was advertised have not helped matters. Such companies are also helping to cause the emergence of drug resistance and treatment failures, some care givers have given what can be considered adequate amounts of the drugs only to discover that the patients are not recovering. Urine cultures or stool cultures that isolate salmonella giving a sensitivity profile has helped in tackling these issues of drug resistance. It has even been discovered in my practice that in many of such sensitivity report, salmonella has been found responding to gentamicin instead of the popular amoxicillin. This has led to result oriented treatment of typhoid fever.
Boiling of drinking water is one single important way to avoid typhoid and paratyphoid infection.
Typhoid and paratyphoid infection should be treated for at least ten days. No body should treat them for less than seven days. Under treatment of these infections are the main reasons for multiple drug resistance. Under treatment of pelvic infections is one major reason for infertility in women whose fallopian tubes eventually get blocked by the same organisms for which treatment has been given. Pelvic infections should not be treated for less than seven days and both partners should be treated. Otherwise one partner can be re-infected by the other.