Doctors grapple with antibiotic resistance

CHENNAI: Along with the rise in influenza, COVID and fever cases, doctors are also witnessing an increase in the use of antibiotics. Some are even using it for common cold, noted doctors, warning against the misuse and overuse of antibiotics that pose serious health risks, including deaths due to antibiotic resistance.

“People tend to self-medicate on the first few days of fever and take antibiotics even for viral infections. They consult a doctor only if the health situation worsens,” said Dr Narendra Nath Jena, senior consultant and head of the department of emergency medicine, Meenakshi Mission Hospital and Research Centre.

Such misuse of the medicine exposes the body to toxic elements and can harm in the long run, including developing antibiotics resistance, he cautioned. In simple terms, overusing it could lead to antibiotic resistance, which means these crucial medicines become ineffective against in the later stages.

Doctors added that completing the course of the medications is important because the dosage is prescribed based on the nature of the drug. If a patient fails to follow the instruction, it could also lead to antibiotic resistance.

Dr Vaibhav Suresh, preventive health specialist, Fortis Hospital, said patients stop medicines immediately after they feel there is some relief. Because of this, the medicine would not work when symptoms worsen. This is all the more dangerous in the case of the vulnerable people like children or elderly who use antibiotics without doctor’s supervision.

“We faced this issue during the pandemic. When these people got sepsis or pneumonia in the later stage, the antimicrobial resistance prevented the medicines from being effective. This led to so many deaths, as COVID also leads to bacterial infections that require antibiotics other than antivirals. As there are no new antibiotics being developed, there is a limitation of drug availability, too. It is the biggest threat to global healthcare and anyone can be at a risk of that,” added Dr Vaibhav.

Losing lives due to antibiotic resistance

The existing regulations do not restrict the sale of antibiotics, due to which many buy it over the counter without prescription even for viral infections, said doctors.

“Antibiotic resistance is very common for oral medications. It can develop across the group of antibiotics that have the same molecule. Even similar group of medications do not work when given intravenously. This resistance develops throughout the community and would reduce the number of antibiotics available for doctors to treat infections. When patients develop resistance to cheaper and easily available drugs, we have to go for specific drugs to treat them, thus raising the cost of medications, too,” said Dr Srinivas Rajagopala, senior consultant, Interventional Pulmonology and Sleep Medicine, and director, Transplant Pulmonology - Lung Failure Unit, Kauvery Hospital.

Experts say India has the worst antibiotic resistance problem due to population and lack of regulations on sale of drugs without prescription.

“Even newborns are resistant to these drugs because it is passed on from the mother. When they require antibiotics in the initial years, it won’t work on them. As they are low on immunity, they become highly prone to infections. We are losing a lot of lives due to this. Some of the antibiotics won’t work on 90 per cent of ICU patients, leaving only a limited number drugs available for treatment,” added Dr Srinivas.

Antibiotics are classified as narrow spectrum and broad spectrum. The former works on specific medications when the exact diagnosis of the infection is known, while latter are antibiotics that work on a number of infections.

“We are worried about resistance to carbapenems, the broad spectrum antibiotics that form the last line of safe and effective drug available for treatment. However, due to increased misuse and overuse, they are ineffective on 70-80 per cent of the patients in some ICUs. When the common antibiotics turn ineffective, we are likely to lose lives. Antibiotics are also given to animals in their food to prevent infections, thus passing on the resistance,” he added.

Doctors also insist on promptly taking necessary preventive measures to reduce the spread of infection. “It is important to seek medical attention, especially if you are at higher risk of complications, such as elderly, children, pregnant women, and those with serious health conditions like respiratory diseases,” said Dr Spoorthi Arun, internal medicine consultant, Promed Hospital.

“To protect yourself from infection, you should get the flu vaccine. Other precautions are washing hands with soap and water regularly; avoiding touching your face, nose and mouth; using sanitizer and wearing mask while travelling; avoiding crowded areas; staying away from people suffering from the flu; and following a healthy diet to improve immunity,” she said. Besides practicing such precautionary steps, people should consult doctors early in case of any such illness so that they would prescribe antiviral medications that would help reduce the severity and duration of the illness. With proper precautions and increasing awareness among the public about the effects of influenza, the outbreak could easily be curbed in its early stages itself, added Dr Spoorthi.

State Drug Controller PV Vijayalakshmi said the authorities had noted the overuse of paracetamol during the pandemic. “Drugs are sold as per the regulations laid by the Drug Control Authority. The sale at pharmacies is monitored to check if there is an any abnormal surge in the sale of antibiotics. The regional officials are also keeping a tab,” she said.