Antibiotic misuse fuels silent, rapid dangers increasingly threatening everyone’s lives

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OPINION

By Dr Benigna G. Namara

In homes, clinics, and pharmacies across Uganda, a dangerous habit has become routine: the overuse of antibiotics for illnesses that do not need them. From childhood diarrhoea and coughs to food poisoning and simple fevers, antibiotics are being prescribed, demanded, and self-medicated at alarming levels. What many people do not realise is that this practice is silently accelerating one of the biggest global health threats of our time, antimicrobial resistance (AMR).

Health experts warn that most diarrhoeal illnesses are self-limiting, whether viral or bacterial, and improve with hydration and supportive care. Only a small fraction, such as severe bacterial infections like cholera or specific cases of bloody diarrhoea, require antibiotics. In fact, for some types of bloody diarrhoea, such as those caused by E. coli O157:H7, antibiotics can make the illness worse rather than better. Yet, antibiotics continue to be used as a reflex response, often pushed by well-meaning parents and enabled by prescribers under pressure.

The problem does not stop there. Coughs, colds, and flu-like illnesses are also frequently treated with antibiotics despite being caused mainly by viruses. These conditions usually resolve with rest, fluids, and simple supportive treatment. Food poisoning, another commonly mismanaged illness, is often toxin-mediated, meaning the damage is caused by toxins already present in the body, not by live bacteria multiplying. In such cases, antibiotics offer no benefit and only expose patients to harm.

A less visible but equally dangerous practice is the overuse of intravenous (IV) medicines. Many patients receive unnecessary IV antibiotics even when they can swallow and would respond well to oral medication. Each unnecessary cannula increases the risk of bloodstream infections and exposes patients to avoidable pain, higher costs, and hospital-acquired infections.

Fever, one of the most feared symptoms, is also widely misunderstood. Rather than being a medical emergency, fever is often the body’s natural defence mechanism. By raising body temperature, the immune system slows down the growth of pathogens and boosts the activity of white blood cells. Treating every fever with antibiotics does not save lives, it weakens the future effectiveness of these life-saving drugs.

The consequences are already visible. Overuse of antibiotics is creating drug-resistant bacteria that no longer respond to common treatments. Infections that were once simple to cure now require stronger, more expensive, and sometimes unavailable medicines. This threatens not only individual patients but the entire health system.

The solution is not complicated, but it requires discipline and courage. Parents must resist the urge to demand antibiotics for every minor illness. Clinicians must commit to prescribing antibiotics only when there is clear evidence of severe bacterial infection. Supportive treatment, such as hydration, nutrition and rest, should be the first line of care in most mild illnesses.

Uganda stands at a crossroads. We can continue down the path of overuse and watch our most powerful medicines fail us, or we can change course now. Protecting antibiotics today means saving our own lives tomorrow.

This article is written as part of my ongoing campaign (#pathogenperspectivewithbeninamara) to fight the spread of antimicrobial resistance. I call upon clinicians, pharmacists, policymakers, parents, and every member of the public to join this fight by promoting responsible use of antibiotics and protecting the effectiveness of these life-saving medicines for current and future generations.