How everyday choices and quick fixes quietly accelerate antimicrobial resistance threat

When antibiotics are used without knowing the cause, they may do nothing at all or make resistance worse. [Courtesy]

The path to antimicrobial resistance (AMR) often begins at home, quietly and without intention. A headache, fever, stomach pain or sore throat feels familiar.

The symptoms resemble something experienced before. Instead of going to a health facility for tests, many people reach for what once worked. A leftover pill, a familiar antibiotic from a nearby chemist or advice from a friend feels quicker, cheaper and easier.

These choices appear practical, especially in a health system where laboratory services are limited, diagnostic tools are scarce and hospitals are frequently overcrowded. Yet experts warn that this everyday decision-making plays a powerful role in driving AMR.

“People often assume they already know what they are sick with,” said Susan Kiambi, a Senior Medical Technologist. “They base treatment on symptoms alone or on what they were given before. Without testing, that assumption is risky.”

Fever is one of the most common examples. In many parts of Kenya, fever is automatically linked to malaria, even in regions where malaria transmission is low. Patients bypass testing and purchase anti-malarial drugs over the counter. In other cases, stomach pain or diarrhoea leads straight to antibiotics commonly used for typhoid, without confirmation that typhoid is present.

“Symptoms overlap across many diseases,” Kiambi explained. “A viral infection, a bacterial infection or even a parasitic illness can look the same at first. When antibiotics are used without knowing the cause, they may do nothing at all or make resistance worse.”

Another widespread habit is returning to drugs used in the past. A cough cleared after antibiotics once, so the same medicine is taken again. A urinary tract infection responded before, so the same tablets are purchased without consultation. Over time, bacteria repeatedly exposed to the same drugs adapt and survive.

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Over-the-counter access to antibiotics makes this cycle easy to sustain. Many chemists sell antibiotics without prescriptions, often under pressure from customers who expect quick relief. While regulation exists, enforcement remains uneven.

Nancy Bowen, Director of Medical Laboratory Services at the National HIV Reference Laboratory. noted that misuse does not stem from ignorance alone. “People are responding to real barriers. Testing costs money. Facilities may be far. Results can take time. When someone feels unwell, they want immediate relief.”

Even when laboratory services are available, many patients skip testing because symptoms feel manageable. That decision carries consequences beyond the individual. Resistant bacteria spread within households, communities and hospitals, quietly undermining treatment options for others. “Antibiotic resistance does not stay with one person,” Kiambi said. “It moves. A resistant infection today becomes a community problem tomorrow.”

Children are particularly vulnerable. Parents may treat fevers or diarrhoea at home using adult medications or incomplete doses. In severe cases, delayed diagnosis leads to complications that could have been avoided with early testing.

Personal responsibility

Experts stress that personal responsibility must exist alongside system reform. Strengthening laboratories, expanding access to diagnostics and investing in surveillance are essential. Behaviour change at the individual level matters just as much.

“When antibiotics are taken unnecessarily or incorrectly, everyone pays the price,” Bowen said. “Even the strongest health system cannot keep up if misuse continues at community level.”

Simple actions can make a difference. Seeking testing before treatment whenever possible. Avoiding leftover antibiotics. Completing prescribed doses fully. Refusing antibiotics when told they are not needed. Asking questions at pharmacies and clinics.

Kiambi emphasised that antibiotics are a shared resource. “Once resistance develops, we cannot reverse it. Protecting these medicines requires careful use, both by health professionals and by the public.”

Antimicrobial resistance is often framed as a policy failure, a laboratory gap or a funding challenge. Those gaps are real. Still, the choices made in homes, shops and pharmacies every day quietly shape the direction of the crisis.