#SpaceYaMedschool

The Official #SpaceYaMedschool Twitter handle |
Creating Public Awareness on Health Matters |
Debunking misinformation |
Spaces every Wednesday at 2100hrs EAT

[#SpaceYaMedschool @Space_MedSchool]

As long as you're alive you have infinite restarts.

(Read we've never been so backkk)

[EgertonUniOHC/AMR @EUOHC_AMR]

DON'T SELF-PRESCRIBE. It is likely that do not need that Azithromycin for that nasal congestion.
ASK QUESTIONS. "is this bacterial or viral?" "why this antibiotic?" "what if I stop prematurely?"
Every small choice matters. Every completed course...
[/21]

[EgertonUniOHC/AMR @EUOHC_AMR]

Here's what we can do though:
FINISH THE COURSE. Especially when you feel better.
DON'T SHARE. Not with friends, or even family. Each infection is unique on its own.
DON'T DEMAND. Let your doctor explain why you might not need antibiotics.
[/20]

[EgertonUniOHC/AMR @EUOHC_AMR]

It would have resolved in 48 hours. Instead, you've just carpet-bombed your gut microbiome, and gave the survivors a resistance masterclass. If you only knew. None of these mistakes feel like mistakes in the moment. They feel like survival, resourcefulness, even love.
[/18]

[EgertonUniOHC/AMR @EUOHC_AMR]

Or perhaps you're on the roads. You pack ciprofloxacin, for the traveler's diarrhea, "just in case". You take it at the first sign of an upset stomach. But most traveler's diarrhea is viral, or self-limiting, or from that left over milk that you quickly reheated and had.
[/17]

[EgertonUniOHC/AMR @EUOHC_AMR]

One reaches the lungs adequately. The other concentrates in urine. You take it anyway. The infection doesn't clear. You go back. They give you something stronger. You've exposed bacteria to two antibiotics. Taught them twice. Created double resistance where none existed.
[/16]

[EgertonUniOHC/AMR @EUOHC_AMR]

Artillery whose reserve is diminishing by the years.
Or the pharmacist doesn't have amoxicillin. He offers you something else. "It's the same thing," he says. But it's not. One targets gram-positive bacteria. The other, gram-negative. Does the pharmacist even regard this?
[/15]

[EgertonUniOHC/AMR @EUOHC_AMR]

Paying heftily for our own affliction. The poetry being that we do it out of love. Out of fear. The desperate wish to do something, anything, when our beloved are unwell. Unbeknownst to us, we are equipping bacteria with tips and tricks to evade all of our artillery.
[/14]

[EgertonUniOHC/AMR @EUOHC_AMR]

Most antibiotics prescribed for respiratory infections: coughs, colds, sore throats, are done so for viral infections they cannot help. Study after study shows it. 30-50% unnecessary. Up to 80% in some settings. We are spending billions training our enemy.
[/13]

[EgertonUniOHC/AMR @EUOHC_AMR]

Except that this fever is viral. Maybe COVID. Maybe flu. Maybe dengue. The antibiotic will do nothing for your child. It will, however, do everything for the bacteria living unperturbed in their gut, their throat, their skin. It will teach them. Train them. Get them ready.
[/12]

[EgertonUniOHC/AMR @EUOHC_AMR]

Or your child has a fever. You remember the doctor that prescribed antibiotics for fever last time. So you go to the pharmacy with nothing but the child's symptoms. The pharmacist, overwhelmed, undertrained, and only in it for the money, sells you amoxicillin. "Try that''.
[/11]

[EgertonUniOHC/AMR @EUOHC_AMR]

No prescription. No nothing. Just some bit of money, and the remotest idea of the drug's trade name. Or what it is for. Your nduthi guy buys pills for his cough. Not enough to cure, just enough to teach resistance. He even tells it to his mates, or to you.
[/10]

[EgertonUniOHC/AMR @EUOHC_AMR]

Those four tablets, the perfect dose for nothing, will accomplish only one thing: teaching her microbes that this antibiotic is something they can survive. Our streets are awash with chemists where you can buy tablets of anything. Amoxicillin. Ciprofloxacin. Azithromycin.
[/9]

[EgertonUniOHC/AMR @EUOHC_AMR]

Your sister has a cough that sounds like yours did last month. You have four tablets left from your prescription. It feels wasteful not to share. It actually feels kind, so you hand them over. But her bacteria are not your bacteria. Her infection is not your infection.
[/8]

[EgertonUniOHC/AMR @EUOHC_AMR]

Streptococci, when not totally and absolutely vanquished, don't die. They learn. They adapt. And we've been teaching them this for seventy years. So much so that we have even taught them dependence – how they can use our medicines as their food.
[/7]

[EgertonUniOHC/AMR @EUOHC_AMR]

...and we just allowed to inherit the earth. In the 1950s, when penicillin was still magic, Sir Alexander Fleming himself warned us: "The ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant."
[/6]

[EgertonUniOHC/AMR @EUOHC_AMR]

Here's what we don't see: antibiotics are not painkillers. They're not treating symptoms. They're waging war. And we just called our troops home before the battle was won. The bacteria that survived the first seven days? They're the genetically armored resilient resistors...
[/5]

[EgertonUniOHC/AMR @EUOHC_AMR]

We stop when we feel better. Of course we do. We're human. The fever breaks on day 3. The cough quiets on day 5. Day 7, we're normal. The bottle says day 10. But we see no point in poisoning ourselves with chemicals we don't need. The immunity, we think, can now take over.
[/4]

[EgertonUniOHC/AMR @EUOHC_AMR]

This is not a thread about villains. This is a thread about the gap between knowing and doing; between what the doctor said and what we heard; the prescription and the practice. This is about the everyday ordinary where all of us are accidentally teaching bugs survival.
[/3]

[EgertonUniOHC/AMR @EUOHC_AMR]

She throws them away. Somewhere, in the dark warmth of her little one's recovering throat, something ominous is cooking. A few streptococci have survived the antibiotic onslaught. They were merely wounded, not killed, and they begin to multiply again.
[/2]

[EgertonUniOHC/AMR @EUOHC_AMR]

11:47 PM. Nairobi. Kenya. A mother, relieved that her daughter's fever has gone away, stares at three white tablets in her palm. Her prescriber, a local pharmacist down the street, said ten days. She's taken seven. The rent is due. These three pills cost 150 shillings.
[/1]