Researchers warn against the increasing use of antibiotics as a preventative measure, noting that this trend could contribute to accelerating the global antibiotic resistance crisis.
Researchers from the Second Faculty of Medicine at Charles University in Prague prepared this cautionary report, which was published in the journal "Clinical Microbiology and Infection," where they discuss the delicate balance between the benefit of prophylactic antibiotics and the risks of overuse.
Researchers emphasize that these drugs, despite their importance in preventing infection among high-risk groups, are increasingly being used in situations that are not always based on a clear medical necessity, which may weaken their long-term effectiveness.
The researchers explain that the problem lies in the fact that giving antibiotics to a large number of healthy people in order to prevent just one infection leads to increased selective pressure on bacteria, which accelerates the emergence of treatment-resistant strains.
The warning discusses four clinical examples that illustrate this problem. The first is the routine use of antibiotics in cases of viral pneumonia, even though their benefit in this situation is limited. The second is the use of doxycycline as post-exposure prophylaxis (Doxy-PEP) to reduce the incidence of certain sexually transmitted infections. The third is the use of vancomycin as a prophylaxis to reduce Clostridium difficile infection. And the fourth is the administration of antibiotics to household contacts to prevent invasive group A streptococcal (iGAS) infection.
As an illustrative example, epidemiological data from the Netherlands indicate that approximately 580 healthy contacts need to be treated to prevent just one case of iGAS infection, often using antibiotics classified as important medicines that the World Health Organization recommends be protected, such as azithromycin and rifampicin.
Researchers emphasize that what is known as "caution" in prescribing antibiotics needs to be redefined, so that it does not mean overusing them preventively, but rather strict adherence to cases based on strong clinical evidence.
The researchers conclude that maintaining the effectiveness of antibiotics requires reducing their unnecessary use and limiting their preventive role to high-risk cases only, to ensure their continued effectiveness in treating patients who need them most.
