Why Responsible Antibiotic Use Matters More Than Ever
- Rephaim Mpofu
- Jun 26
- 4 min read
Updated: Jul 1
Why Responsible Antibiotic Use Matters More Than Ever
A group of leading infectious disease and public health specialists recently wrote an open letter to the South African Department of Health, sounding the alarm on antimicrobial resistance (AMR), a silent but escalating crisis. The letter called for the urgent reinstatement of a national action plan and a dedicated scientific advisory committee to address the growing threat of AMR.[1]
The rise in antibiotic resistance affects every South African household. At MedConnex, we believe it's vital to raise awareness about responsible antibiotic use, and how both doctors and patients play a vital role in combating resistance.
Understanding Antibiotic Resistance
Antibiotics, first discovered by Sir Alexander Fleming, are powerful medications used to treat bacterial infections. But bacteria are smart and constantly evolving to develop ways to resist antibiotics. The more often antibiotics are used, the more likely bacteria are to develop mechanisms that make these medications less effective. As antibiotic resistance increases, common infections become harder, and sometimes impossible, to treat. This leads to longer hospital stays, more complex illnesses, and an increase in preventable deaths.
Antibiotic resistance affects everyone and puts future generations at risk. Once a type of antibiotic becomes ineffective, treatment options become limited, making even routine infections more dangerous. A 2022 study found that among 76 countries, 42% reported high levels of resistance in Escherichia coli, and 35% in methicillin-resistant Staphylococcus aureus (MRSA) to third-generation cephalosporins such as ceftriaxone. In cases of urinary tract infections caused by E. coli, 1 in 5 showed resistance to common antibiotics like ampicillin, co-trimoxazole, and ciprofloxacin.[2]
Various issues arise with the development of antibiotic resistance. This resistance threatens our ability to safely perform life-saving procedures like chemotherapy, organ transplants, and caesarean sections. It also affects the health of animals and crops, leading to food insecurity and reduced farm productivity. Meanwhile, the economic cost is significant. AMR leads to higher treatment costs, prolonged hospital stays, and lost productivity. As seen during the COVID-19 pandemic, infectious disease threats do not respect borders. AMR is a global issue, affecting countries of all income levels. The Organization for Economic Cooperation and Development (OECD) projects a twofold increase in resistance to last-resort antibiotics by 2035 compared to 2005. These projections highlight the urgent need for improved antimicrobial stewardship practices and enhanced surveillance coverage worldwide.
What Is Antibiotic Stewardship?
Antibiotic stewardship means the careful and responsible use of antibiotics to ensure they remain effective. It involves healthcare providers making informed decisions about whether antibiotics are needed, and if so, choosing the right drug, dose, and duration. Stewardship also means avoiding antibiotics when they are unlikely to help, such as in viral infections.
How do healthcare providers decide when to prescribe antibiotics?
There are several considerations that healthcare providers consider before prescribing antibiotics, including:
Type of infection: Antibiotics only work against bacteria. This is why antibiotics are usually not required for viral illnesses such as the common cold or flu.
Severity and symptoms: Mild infection often resolve without antibiotics. More serious or persistent symptoms might warrant further testing and treatment with antibiotics.
Diagnostic evidence: When the cause is unclear, healthcare providers might order tests (like a throat swab, urine test, or blood culture) to confirm a bacterial infection before prescribing.
Patient history: Past reactions, allergies, history of frequent infections, or recent antibiotic use. For example, someone who was recently treated with an antibiotic like co-amoxiclav may require a different antibiotic if deemed necessary.
When Are Antibiotics Appropriate for Patients?
As a patient, it's important to know that antibiotics are not a cure-all. They may be appropriate when:
You have a confirmed bacterial infection (e.g., strep throat, urinary tract infection, certain types of pneumonia).
Your symptoms persist or worsen after a few days, suggesting something beyond a viral illness.
You have factors that place you at high-risk of severe illness and complications, e.g., elderly, immunocompromised.
Healthcare providers may say “Let’s Wait”
Sometimes your doctor might recommend monitoring symptoms before prescribing anything. Research shows that this is a safe and effective approach and does not increase the risk of complications. This strategy helps avoid unnecessary antibiotic use, which reduces the risk of developing resistance.
If your symptoms worsen or don’t improve, a follow-up consultation can lead to further testing or treatment.
What can you do to help prevent antibiotic resistance?
Everyone can play a role in preventing antibiotic resistance. Here are a few ways:
Support smart antibiotic use: Work with your doctor to decide whether antibiotics are truly necessary for your condition.
Follow the prescription exactly: If antibiotics are prescribed, complete the full course, even if you start feeling better.
Never share or reuse leftover antibiotics.
Practice good hygiene: Wash hands regularly to prevent the spread of infections.
Stay up to date with vaccines to prevent infections that could otherwise require antibiotics.
Why It Matters Now
As highlighted in the open letter, South Africa currently lacks an updated national strategy to address antibiotic resistance. Without coordinated action, resistant infections may become more common, more deadly, and more expensive to treat.
At MedConnex, we support the call for urgent policy action, but we also believe that individual actions count. Every time antibiotics are used appropriately, we help preserve their effectiveness for future generations.
Photo credit – Header image designed by Freepik
References:
1. Marc Mendelson, Moritz van Vuuren, Chetna Govind, Adrian J Brink, Natalie Schellack, Nicolette M du Plessis, et al. Need to Reinstate a National Action Plan and Scientific Advisory Body on Antimicrobial Resistance in South Africa [open letter]2025. Available from: https://groundup.org.za/media/uploads/documents/open_letter_to_minister_motsoaledi_final-20250619.pdf.
2. World Health Organization. Global antimicrobial resistance and use surveillance system (GLASS) report 2022. Geneva; 2022.
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