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  • Why the Way We Use Antibiotics Matters More Than We Think

    Why the Way We Use Antibiotics Matters More Than We Think

    A closer look at everyday antibiotic use and caregiving in rural communities in Vietnam.

    What is antimicrobial resistance?

    Antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi, or parasites no longer respond to medicines designed to kill them [1]. As a result, antibiotics and other antimicrobial drugs become less effective, making infections harder to treat and increasing the risk of severe illness and spread. Contrary to popular belief that people become “resistant” to antibiotics, it is the microorganisms (e.g. bacteria) that adapt and survive exposure to these drugs. The more frequently antimicrobials are used, especially when they are used unnecessarily or incorrectly, the greater the opportunity for resistant strains to emerge and spread [1].

    The scale of the global problem

    Antimicrobial resistance is already a major global health threat. In 2019, nearly 5 million deaths worldwide were associated with bacterial AMR, including 1.27 million deaths directly caused by drug-resistant infections [2]. Many of these deaths were linked to common illnesses, such as lower respiratory infections, and familiar bacteria like Escherichia coli and Staphylococcus aureus. These figures show that AMR is closely connected to everyday healthcare, not just rare diseases or hospital settings. 

    Because of its scale and complexity, AMR has been identified as a global problem that demands a global response. However, while scientific research is essential, efforts to control resistance must also consider the social and healthcare contexts in which antibiotics are used [3].

    Antibiotic use in everyday healthcare

    In many parts of the world, antibiotics are not used only in hospitals or prescribed strictly by doctors. Instead, they are often accessed through informal or semi-formal healthcare settings, including pharmacies and drug sellers, and are commonly used to manage everyday symptoms such as coughs, colds, or fevers [4,5]. Decisions about antibiotic use are rarely based on medical knowledge alone. They are shaped by practical concerns, such as cost, convenience, time, access to healthcare, social expectations and caregiving responsibilities within families [4,5,6]. In these situations, uncertainty, worry, and the fear of delaying treatment often influence choices, especially when caregivers feel responsible for protecting their family’s health.

    Recognising the urgent need to better understand how antimicrobial resistance develops beyond laboratories and hospitals, Collab Lab has chosen to animate a relevant study – “Dilemmas of care: Healthcare seeking behaviours and antibiotic use among women in rural communities in Nam Dinh Province, Vietnam.” The research looks at how women, who are often the primary caregivers in their families, navigate healthcare decisions and antibiotic use in rural settings [6]. 

    Through this project, we hope to spark curiosity and conversation about antimicrobial resistance and encourage young audiences to think more deeply about how science, society, and everyday choices are connected.

    Stay tuned for the next episode of Collab Lab!

    References

    1. World Health Organization. Antimicrobial resistance. World Health Organization. Published November 21, 2023. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance

    2. Antimicrobial Resistance Collaborators. Global Burden of Bacterial Antimicrobial Resistance in 2019: a Systematic Analysis. The Lancet. 2022;399(10325):629-655. doi:https://doi.org/10.1016/S0140-6736(21)02724-0

    3. Wellcome Funding. What is antimicrobial resistance – and how do we prevent it? | News and reports | Wellcome. Wellcome. Published May 21, 2024. https://wellcome.org/insights/articles/what-antimicrobial-resistance-and-how-do-we-prevent-it

    4. Denyer Willis L, Chandler C. Quick fix for care, productivity, hygiene and inequality: reframing the entrenched problem of antibiotic overuse. BMJ Global Health. 2019;4(4):e001590. doi:https://doi.org/10.1136/bmjgh-2019-001590

    5. Rodrigues CF. Self-medication with antibiotics in Maputo, Mozambique: practices, rationales and relationships. Palgrave Communications. 2020;6(1). doi:https://doi.org/10.1057/s41599-019-0385-8

    6. Nguyen YHT, van Doorn R, Van Nuil JI, Lewycka S. Dilemmas of care: Healthcare seeking behaviours and antibiotic use among women in rural communities in Nam Dinh Province, Vietnam. Social Science & Medicine. 2024;363:117483. doi:https://doi.org/10.1016/j.socscimed.2024.117483

  • Old Drug, New Hope: Testing Metformin Against Dengue

    Old Drug, New Hope: Testing Metformin Against Dengue

    Scientists are taking a fresh look at a common diabetes pill to see if it might help protect overweight and obese patients from severe dengue.

    Traditionally, efforts to combat dengue have focused on preventing mosquito bites and managing symptoms rather than curing the infection itself. Most of the time, treatment involves symptom relief, using medications such as paracetamol (acetaminophen) to ease headaches and reduce fever.

    From January to July 2025, dengue has caused over 4 million infections and more than 3,000 deaths, according to reports from the World Health Organization covering 97 countries [1]. Unfortunately, there is still no specific treatment for this disease.

    Because there is no approved antiviral drug for dengue, the search for effective treatments has become an urgent global priority. Researchers around the world are now investigating whether existing, affordable medicines could help reduce the severity of the disease.

    Why Focus on Overweight and Obese Patients?

    Research has shown that people living with obesity are more likely to develop severe dengue, partly due to how obesity affects metabolism and immune function. In Vietnam, nearly one in five children is overweight, and 8% are obese [2]. As dengue continues to rise, researchers worry that its overlap with obesity could make infections even more dangerous in the future.

    But why does obesity matter in dengue? Scientists suspect several biological mechanisms behind this link. Obesity can cause chronic, low-grade inflammation, which may make the immune system overreact when infections happen [3,4]. It can also weaken key immune cells and alter how the body processes lipids, which are the materials the dengue virus uses to build its outer layer. More importantly, obesity also reduces the activity of an enzyme called AMPK, which normally helps regulate metabolism and control inflammation. 

    That’s where metformin enters the picture.

    Metformin is a common and affordable medication for type 2 diabetes. But why is a diabetes drug being tested for dengue? It is because Metformin works by activating the AMPK enzyme, which becomes less active in obese people. 

    In laboratory studies, activating AMPK with metformin has been shown to limit dengue virus replication, and observational research found that diabetic patients who regularly took metformin were less likely to develop severe dengue.

    Beyond that, metformin also has anti-inflammatory and blood vessel–stabilizing effects, which could help reduce complications seen in severe dengue. Because it’s safe, affordable, and widely available, researchers saw metformin as a promising candidate to test as an additional therapy for dengue—especially in overweight and obese patients, whose disrupted metabolism may give the virus an advantage.

    Given the ongoing search for effective dengue treatments, Collab Lab has chosen to animate the MeDO study — “Safety and tolerability of metformin in overweight and obese patients with dengue: An open-label clinical trial”. This research focuses on two key factors, which are obesity and metformin, and examines how they interact in dengue patients. Through this, we hope to spark public interest in innovative, accessible solutions for global health challenges.

    Stay tuned for the first episode of Collab Lab, Season 4, featuring an entirely new production team!

    References:

    1. World Health Organization. (2025, August 21). Dengue. Who.int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue 

    2. Van Minh, H., Khuong, D. Q. L., Tran, T. A., Do, H. P., Watson, F., & Lobstein, T. (2023). Childhood Overweight and Obesity in Vietnam: A Landscape Analysis of the Extent and Risk Factors. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 60, 004695802311546. https://doi.org/10.1177/00469580231154651

    3. Nguyen, N. M., Thi, D., Ho Quang Chanh, Trieu, H. T., Xuan, T., Van, N. T., Phong, N. T., Tam, C. T., Hong, T., Hue, T., Cam, T., Thi, L., Hao, N. V., Qui, P. T., Thi, T., Hai, T., Thuy, T., Tho, P. V., Le, T., & Thuy, V. T. (2025). Safety and tolerability of metformin in overweight and obese patients with dengue: An open-label clinical trial (MeDO). PLoS Neglected Tropical Diseases, 19(7), e0013281–e0013281. https://doi.org/10.1371/journal.pntd.00132814. Jeon, S.-M. (2016). Regulation and Function of AMPK in Physiology and Diseases. Experimental & Molecular Medicine, 48(7), e245–e245. https://doi.org/10.1038/emm.2016.81