Because of antibiotic misuse and overuse: Bulgaria has the highest death rate from antimicrobial resistance

Bulgaria has the highest mortality from bacterial infections that are antibiotic resistant. Due to overuse and improper treatment, this country is at the top of the so-called antimicrobial resistance.

This means that the number of people for whom antibiotics no longer work is increasing. Nearly 5 million people are losing their lives because of this problem. The World Health Organisation identifies antimicrobial resistance as one of the top 10 global threats to the world's population.

It is predicted that, if no measures are taken, by 2050 the toll of reduced antibiotic susceptibility will reach 10 million people a year.

Dr Daskalova is a paediatrician. In recent years, she has noticed that the number of children for whom the most of the available antibiotics do not work is increasing.

"This is due to their frequent use, to the self-medication that many patients conduct. Antibiotics are not candy, they are not syrup that is juice for children. It is a strictly defined medication that is prescribed only by a doctor," said Dr Denitsa Daskalova, a general practitioner.

However, many people self-prescribe antibiotics for sore throats, colds, fever and incorrectly treat viral infections with them. And so they risk developing so-called antimicrobial resistance.

"No single antibiotic works on the bacterial species in question. Antibiotics are a drug with a predictable end of action, because bacteria will build up resistance to any new antibiotic that is invented," added Dr Alexander Kolevski, head of the microbiology laboratory, University Hospital Alexandrovska.

Increasingly, Dr Kolevski is doing specific tests to combine antibiotics from different groups for resistant patients.

"Our success rate is quite high, but it's not what should be expected, given that we had a pretty powerful weapon against bacteria until 15 years ago," Dr. Ales Kolevski added.

"We are in one of the first places in terms of mortality rate because of the lack of sensitivity to certain antibiotics. It occurs because of this overuse," said Mikhail Okoliski, deputy minister of health.

In order to curb antimicrobial resistance, the inappropriate use of antibiotics must be reduced. To this end, next year, the health authorities plan to activate a national programme that has been sitting on the shelves since 2019.

"One should not buy antibiotics without having them prescribed by a doctor and without having an antibiogram. If we don't do this, more and more treatable infections will become difficult to treat," said Mikhail Okoliski.

New antibiotics are not being produced. The national programme includes measures to limit the use of antibiotics in animals and the environment.

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