Self-medication, defined as the practice of taking medication on one’s own initiative without the prescription or supervision of a healthcare professional, is a global phenomenon with profound implications for public health. Regarding to sexually transmitted diseases (STDs), this practice becomes even more dangerous due to the increasing threat of antibiotic resistance, a problem that is already getting alarmingly big within the medical field. This post aims to detailly describe why self-medication is not only a mistake for STDs treatment, but also a direct contributor to the acceleration of antibiotic resistance, and, therefore, a significant hazard for public health.
Understanding antibiotic resistance
In order to understand why self-medication is so dangerous, it is essential to comprehend the phenomenon of antibiotic resistance. This term refers to the ability that specific pathogenic microorganisms, like bacteria and fungi, develop to resist the effects of medicaments that used to kill them or avoid them from growing. This process happens due to genetic mutations that can be selected and spread in a microbial population in presence of antibiotic. As time goes by, these resistant bacteria can become dominant, which leads to much harder treating diseases.
One of the main causes behind antibiotic resistance is the inappropriate use of these medications. This includes the use in excess, as well as the incorrect use, where self-medication can be found. When antibiotics are misused, bacterial survivors with the capacity of resisting treatment can be left. These survivors can multiply and spread their resistance to other microbes, worsening the problem.
Sexual transmitted diseases: Fertile ground for resistance
Sexually transmitted diseases, including infections like gonorrhea, chlamydia, syphilis and HIV, are caused by a variety of pathogenic agents like bacteria, viruses and parasites. If these infections are not treated appropriately, they can lead to severe complications, including infertility and chronic diseases. Antibiotics have been an essential tool in the treatment of many bacterial STDs, but their efficacy is being threatened by antimicrobial resistance.
Regarding Neisseria gonorrhoeae, the bacterium that causes gonorrhea, it is a highly alarming matter. This bacterium has developed resistance to almost every antibiotic used for its treatment since the 1940s, including penicillin, tetracycline, macrolides and quinolones. Self-medication contributes directly to this problem, as the misuse of antibiotics can accelerate the formation of these resistant strains.
The dangers of self-medication for STDs
Self-medicating to treat STDs presents multiple dangers that contribute to the development and spreading of antibiotic resistance. These dangers include:
-
Incorrect diagnosis
One of the biggest disadvantages of self-medication is the lack of an accurate diagnosis. Many STDs present similar symptoms, and some can even be asymptomatic during their early stage. Without an appropriate diagnosis, one could be treating a different infection than the one they actually have, which is not only ineffective, but also a contributing factor to resistance when the wrong antibiotics are being used. In addition, self-medication can significantly reduce the tests’ sensitivity, which can lead to a false negative result.
-
Incorrect dose
The success of an STD treatment depends on administrating the correct dose of antibiotic during the prescribed period of time. Self-medication usually results in the administration of incorrect doses, either too low or too high ones, which can be ineffective or even dangerous. Subtherapeutic doses are particularly problematic as they are not able to completely eradicate de infection, what allows resistant bacteria to survive and reproduce.
-
Selection of inappropriate antibiotics
Not every antibiotic is effective for every bacterium. The election of the antibiotic depends on factors like the bacteria type and its sensitivity profile. Without a sensitivity test, which can only be carried out in a clinical laboratory, the risk of using an inappropriate antibiotic increases, and that does not only fail to treat the infection, but also encourages resistance in other bacteria present in the organism.
-
Premature treatment interruption
Those who self-medicate can interrupt their treatment as soon as the symptoms disappear, but that does not mean that the infection has been eradicated. Premature interruption allows the surviving bacteria, which can be more resistant, to keep reproducing.
Consequences for public health
The impact of self-medication regarding STDs does not limit to the one who self-medicates; the consequences extend to the general community and have severe implications for public health:
-
Propagation of resistant bacteria
Those who don’t receive an appropriate treatment can still carry and transmit resistant bacteria, spreading to others strains that are more difficult to treat.
-
Increase of healthcare costs
Antibiotic resistance leads to extended treatments, the need of more expensive medicaments, hospitalizations and, in some cases, the impossibility of treating the infection. These increases costs for healthcare systems and for patients.
-
Loss of therapeutic options
As we have already mentioned, in the case of gonorrhea, therapeutic options are already limited. If resistance keeps spreading, we could face a scenario where some STDs can’t be treated with the available antibiotics.
-
Risk of Serious Complications
Poorly treated STDs can lead to severe complications. In women, for example, chlamydia and gonorrhea can cause pelvic inflammatory disease, which in turn may lead to infertility. In men, untreated gonorrhea can lead to epididymitis, which can also result in infertility.
The role of education and community awareness
A key strategy to fight self-medication and, therefore, antibiotic resistance is public education. The population needs to understand the risks associated with self-medication and the importance of seeking appropriate healthcare. This includes educating about STDs symptoms, the need of an appropriate diagnosis and the importance of strictly following medical instructions.
The medical responsibility must be emphasized, as they must be careful with antibiotic prescription, making sure they are only used when they are strictly needed and with the appropriate dose and duration.
Conclusion
Self-medication is a serious mistake in relation to sexual transmitted diseases, with consequences that extend beyond the oneself. It contributes significantly to the global problem of antibiotic resistance, a challenge that threatens to go decades of medical advances back. Only through education, appropriate healthcare and responsible use of antibiotics will we be able to stop the spread of resistance and make sure that STDs can still be treated in the future.
In Open House we are aware of the challenge that entails the emerging antibiotic resistance, that’s why we will never prescribe you an antibiotic without a clear and justified reason and a specialized medical consultation.
If you suspect you might have an STD, our specialized medical team is the best solution. They will be able to orientate you about what tests to go under and, if you have obtained a positive result, they will administrate you the appropriate treatment guaranteeing your health. You can come to our clinics in Madrid or Valencia or you can have a remote consultation, by videocall or by phone, if you want to avoid the trip.
Always leave your sexual health in the hands of the best qualified professionals, count on the Open House medical team.
Madrid Clinic Valencia Clinic Remote Consultation
Dr. Atef Souied Espada