Antibiotics are drugs which have saved and still saving hundreds of thousands of lives every year. Antibiotics are possibly the most vital advancement in the history of medicine and undoubtedly; they are among medicine's most prevailing sector. But the other side of the coin offers us “antibiotic resistance” which is a serious and one of the most threatening healthcare problems worldwide

1. The Usage of Antibiotics in Bangladesh
Prepared By:
Tareq Tareq,
B.Pharm Student,
International Islamic University Chittagong,
Bangladesh.

2. Introduction
 Antibiotics are drugs which have saved and
still saving hundreds of thousands of lives
every year. Antibiotics are possibly the most
vital advancement in the history of medicine
and undoubtedly; they are among medicine's
most prevailing sector. But the other side of
the coin offers us “antibiotic resistance” which
is a serious and one of the most threatening
healthcare problems worldwide

3. Antibiotics prescriptions
 In Bangladesh Antibiotic prescription is the
highest for those aged 5 to 11, and above 65
years. Males had 20% more antibiotics than
females.

4. Extent of uses
According to a recent study, the extent of usage of various
antibiotics that are available in Bangladesh:
 Ceftriaxone, a third generation cephalosporin is by far the most
used antibiotic (30.19%)
 cefixime, another third generation cephalosporin and it was used
18.9% of the time
 Amoxycillin (16.98%)
 ciprofloxacin, metronidazole and cefuroxime follows the list.
 The least used antibiotics were Cefepime and Erythromycin.
(Australasian Medical Journal AMJ 2010, 3, 7, 414-421)

5. highest antibiotic usage
Acoording to a study conducted in Bangladesh
 Physical assault,
 General weakness,
 acute watery diarrhea,
 Acute trauma,
 Gastrointestinal distress (GID),
 Respiratory diseases and
 Post partum cases in descending order were the top
seven classes of diagnoses which resulted in most
frequent antibiotic prescriptions.

6. RESISTANCE IN BANGLADESH
Bacterial resistance is one of the major causes of failure
in the treatment of infectious diseases and results in
increased morbidity, mortality, and cost. Studies
conducted in Bangladesh suggested that
●Pseudomonas aeruginosa responsible for wound, urine,
ear, throat and other infections were more than 50%
resistant to commonly used antibiotics used in
Bangladesh including ciprofloxacin, gentamicin,
ceftriaxone, cefixime and azithromycin.

7. RESISTANCE IN BANGLADESH
● Azithromycin was 100% ineffective in wound
and urine infections, while ceftriaxone and
cefixime was 100% ineffective in tracheal
infections.
● E.Coli was resistant in 40% of cases to
commonly used ceftriaxone, levofloxacin,
ciprofloxacin, amoxicillin and ampicillin and 95%
resistant to azithromycin. Klebsiella pneumoniae
also showed similar patterns

8. Causes of resistance in Bangladesh
In Bangladesh, poultry and fishing industries are using low doses of
antibiotics as growth-promoting agents. Farmers have also used
antibiotics to try to prevent illness in animals. This prevalence of
antibiotics in livestock means that there are always some bacteria
that are fighting against the medicine, becoming successful at being
resistant and then getting excreted into the environment. There they
are exposed to chemical fertilizers, pesticides and other
antimicrobial agents that create pressure for bacteria to maintain
their resistance characteristics with the result that we are getting
drug-resistant bacteria in our water and soil. Drug-resistant bacteria
can travel wide and far through soil. These resistant bacteria can
teach other bacteria how to become resistant and spread fast and
have the ability to re-enter in the animal through pasture or forage.

9. Causes of resistance in Bangladesh
In Bangladesh, misuse and waste of
antibiotics appear to be frequent. Over the
counter availability of all types of antibiotics
has worsened the situation. Development of
a progressively antibiotic resistant microbial
ecosystem in Bangladesh is thought to be
evoked due to widespread and irrational use
of antibiotics

10. Causes of resistance in Bangladesh
It was found that most of the doctors prescribe antibiotics
in suspected infection (61.0%,) rather than being
confirmed about the infection. Again, according to
majority of the doctors, though not sigfinificant, they
prescribe antibiotics in cold and fever before diagnosis. It
was found that more than 50% of the physicians do not
always receive any feedback about completion of
dosage regimen from their patients. Moreover, a
significant proportion of physicians claimed that they
never receive any feedback from their patients in this
regard. Annual Research & Review in Biology
4(9): 1421-1430, 2014

11. Causes of resistance in Bangladesh
Recent study showed that about half of the
antibiotics were sold without any
prescriptions, and even ordinary people
without any knowledge of medicine asked the
drug seller for specific antibiotics [18]. Rural
people do not always do what the prescribers
advise them to do.