A Veterinary Doctor, Dr Sati Ngulukun, says that the widespread misuse of antibiotics to treat viral illnesses is accelerating antimicrobial resistance (AMR) and threatening the effectiveness of life-saving medicines.
Ngulukun, a Director of Research at the National Veterinary Research Institute (NVRI), Vom, Plateau State, said this in an interview on Tuesday in Abuja.
Ngulukun advised that antibiotics should not be used as the first line of treatment for viral infections such as dengue fever unless there was clear evidence of a secondary bacterial infection.
He explained that dengue, a mosquito-borne viral disease, commonly presents symptoms of fever, low white blood cell count (leukopenia), low neutrophil count (neutropenia), low platelet count (thrombocytopenia), skin rashes and fatigue.
According to him, these symptoms often prompt patients and even some healthcare providers to assume that antibiotics are necessary, in spite of the illness being caused by a virus.
“With dengue, antimicrobial stewardship starts with the clinical story, not with the antibiotic decision.
“If we react to every abnormal laboratory result with antibiotics, we risk over-treating what is essentially a viral infection.
“But if we ignore changes in the patient’s clinical condition, we may miss a secondary infection,” he said.
Ngulukun noted that fever, leukopenia, neutropenia and thrombocytopenia are expected features of dengue and should not automatically trigger antibiotic therapy.
Instead, he advised clinicians to closely monitor patients through supportive care, adequate hydration, repeated clinical assessments and careful observation before deciding whether antibiotics are warranted.
He cited a recent dengue case in which a patient presented with persistent fever and significant reductions in white blood cells and neutrophils but initially improved with supportive treatment alone.
However, after nearly 24 hours without fever, the patient’s condition changed as the fever returned alongside new mucosal symptoms, prompting further clinical evaluation.
“It is not the fever alone or the neutropenia that informed the decision to start antibiotics.
“It is the evolving clinical story and the emergence of new signs suggesting a possible secondary bacterial infection,” he said.
Ngulukun noted that antimicrobial stewardship did not mean avoiding antibiotics altogether or prescribing them “just in case.”
“Rather treatment decisions should be guided by a careful clinical assessment and evolving patient conditions,” he said.
The director urged healthcare workers to continually assess whether a patient’s symptoms remain consistent with the expected course of a viral illness or indicate the development of a secondary bacterial infection.
He also advised members of the public against self-medicating with antibiotics whenever they develop a fever, emphasising that not all fevers require antibiotic treatment.
According to him, improving community awareness about the appropriate use of antibiotics is essential to preserving the effectiveness of existing medicines and slowing the spread of antimicrobial resistance.
“Laboratory investigations is important.
“Careful clinical assessment and patient history are often more valuable in determining when antibiotic therapy is truly necessary,” he added.
Ngulukun urged Nigerians experiencing persistent fever or worsening symptoms to seek prompt medical attention rather than resort to self-medication.
He noted that responsible antibiotic use is a shared responsibility in protecting public health.
He further noted that a growing global public health threat can make bacterial infections more difficult to treat and increase the risk of severe illness and death.
Report shows that dengue is a mosquito-borne viral disease that can cause symptoms ranging from mild fever to severe illness.
It is caused by a virus.
Antibiotics do not treat the infection itself but are recommended only when there is evidence of a secondary bacterial infection.
Health experts have consistently warned that the misuse and overuse of antibiotics were among the leading drivers of antimicrobial resistance.
