Dr. Alireza Najafi, general practitioner at Razi Hospital in Mahneshan, warned about the dangers of antibiotic resistance resulting from excessive and improper use of antibiotics, identifying the destruction of beneficial bacteria in the body as one of the serious side effects of these drugs. In an interview with Webda–Zanjan, Dr. Najafi reviewed the history of antibiotic discovery, noting that before the 20th century, humanity had no access to these “miracle drugs,” and even simple bacterial infections were a leading cause of death. Today, many of these diseases can be easily treated with a single course of antibiotics. Explaining the mechanism of action, he stated that antibiotics work by interfering with bacterial metabolism and halting their activity. However, two dangerous phenomena are now observed: self‑medication with leftover or previously prescribed antibiotics, and patients with viral or fungal infections insisting on antibiotic prescriptions.

Dr. Najafi identified antibiotic resistance as the most serious consequence of overuse, explaining that bacteria become resistant to drugs that were once effective, losing their sensitivity. As a result, stronger antibiotics with more severe side effects must be used. He cited azithromycin as an example, noting that while it was once effective for respiratory infections, its efficacy has declined due to widespread misuse, particularly during the COVID‑19 pandemic. Highlighting the global implications, Dr. Najafi stressed that developing a new, effective antibiotic requires more than 20 years and enormous financial investment. If bacterial resistance continues, humanity may face conditions similar to those before the 20th century, when even simple infections were untreatable—a looming global health crisis. He further pointed to direct side effects of improper antibiotic use, including gastrointestinal issues such as bloating, diarrhea, and nausea, skin reactions, and most importantly, the destruction of beneficial bacteria. Explaining the role of beneficial bacteria, Dr. Najafi noted that they not only contribute to the production of certain vitamins but also occupy vital niches that prevent pathogenic bacteria from proliferating. Their destruction can pave the way for secondary infections. He added that prematurely discontinuing antibiotics or failing to complete the prescribed course is another major factor in resistance, as incomplete treatment allows weaker bacteria to survive and evolve into resistant strains.Dr. Najafi strongly advised citizens to avoid self‑medication with antibiotics and to refrain from pressuring physicians to prescribe them, emphasizing that viral and fungal diseases cannot be treated with antibiotics.