No Filipino, regardless of age, place of birth or social status, should die from a vaccine preventable disease. This was the underlying theme of a scientific lecture conducted recently by a world-renowned infectious disease expert who visited the country to share his views about antimicrobial resistance and pneumococcal conjugate vaccine (PCV) use in treating pneumococcal diseases.
“Pneumococcal disease is one of the leading causes of morbidity and mortality worldwide,” says Ron Dagan, professor of pediatrics at Ben-Gurion University of Negev, Israel who specializes in infectious diseases and immunization as well as respiratory infection and pneumococcal diseases. “Many cases are preventable with vaccination, but unfortunately, the vaccines do not reach all children.”
Pneumococcal disease is an infection caused by Streptococcus pneumoniae bacterium,which can often lead to pneumonia, meningitis (swelling of the membranes covering the brain and spinal cord), and bacteremia (presence of bacteria in the blood). According to the World Health Organization (WHO), up to 1.6 million people die each year globally as a result of pneumococcal diseases. Of this number, about half are children aged 5 years old and younger, with most of the deaths occurring in developing countries.
According to Prof. Dagan, the development of antibiotic resistant pneumococcal bacteria can be traced back to the prescribing physician. “The practice of doctors to treat patients who present with cough, weakness and a raised temperature with antibiotics either for fear of misdiagnosing a bacterial pneumonia or the pressure to help to an uncomfortable patient is not an uncommon one,” he said.
Physicians have an innate desire to ease suffering. However, as Prof. Dagan had pointed out, “first, do no harm”, meaning that before prescribing antibiotics, one must carefully weigh all consequences. If a patient presents with mild symptoms that might just warrant supportive therapy, they should just send the patient home with the advice to return if symptoms persist or worsen. If they strongly suspect that the patient is suffering from bacterial pneumonia, then treatment with an antibiotic is initiated.
However, the latter is usually the case in only approximately 10% of community-acquired infections. Thus, judicious dispensing of antibiotics is necessary in preventing the development of antimicrobial resistance in bacteria.
In closing, Prof. Dagan suggests a two-fold approach to help break the antibiotic-resistance cycle: firstly is to vaccinate all eligible children, and secondly, to prescribe antibiotics judiciously. Children should also be vaccinated in a timely manner, ensuring that the recommended doses are received.
Parents, meanwhile, should keep an open communication line with their doctors. They should partner with their physicians and ask the necessary questions in taking care of their children. We all have a role to play in fighting serious infections including pneumococcal diseases.
The first step is prevention through vaccination and completion of the necessary doses. The second step is to foster an environment where judicious use of antibiotic treatment thrives because prevention and appropriate treatment are essential steps in our collective fight against antimicrobial resistance.