Antibiotic Resistance: Rational Use Of Antibiotics Is Important, Suggests Doctor

Antibiotics have been the bedrock of modern medicine for several decades. Unfortunately, many of these magic bullets have been beaten by disease-causing bacteria because of antibiotic resistance, a condition in which the bacteria can no longer be killed or controlled by specific antibiotics. Overuse of antibiotics is a major contributor to this resistance and is threatening our ability to treat common infections. Antibiotics are becoming less effective because of which a growing list of infections such as tuberculosis, urinary tract infections and some cases of pneumonia are becoming harder, and sometimes even impossible to treat.

We do not have many new antibiotics in the pipeline, so we need to preserve what we have and use antibiotics judiciously. The public, pharmacists and physicians together have a role to play to ensure that antibiotics are consumed rationally.

Also read: Natural Antibiotics: Here's How They Can Boost Immunity And Facilitate Speedy Recovery

Antibiotics: What the public should know

Antibiotics are only effective against bacteria, not viruses. Therefore, not all cases of diarrhoea, cough and conjunctivitis need antibiotics. In fact, viruses are also the single most common cause of sore throat, accounting for 25% to 45% of all cases. This is why patients should refrain from 'self-medicating' with antibiotics. Instead, they should speak to their doctor who can differentiate between bacterial and viral infections and therefore prevent unnecessary antibiotics.

Several laboratory tests can provide useful information to help the doctor identify the disease-causing organism and decide on which antibiotics should be selected and whether the existing treatment dose should be reduced or even discontinued.

Also read: World's Most Prescribed Medicine: Antibiotics

What the pharmacists should not do

Pharmacists are an important part of the health ecosystem, but they should refrain from selling antibiotics over the counter sale, without a valid doctor's prescriptions. Recently, India's Central Drugs Standard Control Organisation (CDSCO) issued an advisory¹ that called on the All India Organization of Chemists and Druggists to educate its members on the sale of these antibiotics.

What the physicians should do

Physicians should prescribe antibiotics rationally, based on several factors such as:

• The site of the infection: The location often influences the choice and dose of the antibiotic to be used.
• The likely disease-causing organism: The type of bacteria determines the choice of antibiotic. In case of a virus, antibiotics will not clear the infection - but may sometimes be prescribed to avoid a secondary bacterial infection.
• The type of antibiotic: Antibiotics work in different ways and either kill or stop the growth of bacteria. Some antibiotics are effective against a few types of bacteria, while others are effective against a wider range and may therefore kill some of the body's healthy bacteria as well.
• The patient's reaction: Unwanted side-effects or a known allergy to a drug influences what antibiotics should be prescribed.

Also read: Here's What You Should Eat With Antibiotics

In addition, physicians should speak to patients about the right way to take antibiotics. Hospitals should enforce strict infection control measures and have a surveillance system to track the occurrence of antibiotic resistant infections. It is also important to educate the public on the importance of staying up to date with vaccinations and practicing good hand hygiene to prevent the need for antibiotics.

India's 2012 'Chennai Declaration' is a roadmap to tackle the challenge of antimicrobial resistance in the country and has been widely appreciated globally. In India, these efforts have resulted in government checks to reduce/prohibit over-the-counter sale of antibiotics without a valid prescription; and better surveillance of antibiotic resistance through the Indian Council of Medical Research's network. A continuation of these efforts at the local and national levels will help us curb antibiotic resistance to ensure that the drugs we have stay effective for years to come.

¹https://cdsco.gov.in/opencms/opencms/system/modules/CDSCO.WEB/elements/download_file_division.jsp?num_id=NTM3Nw==

(Dr Neha Gupta, Consultant - Infectious Diseases, Medanta, Delhi NCR)

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