End arbitrary use, sale of antibiotics

The death of a 70-year-old American woman, who was treated multiple times in India, has put ‘misuse’ of antibiotics under the scanner. With her death being linked to antibiotic resistance, the issue brings to the fore the issue of  rampant abuse of antibiotics. 

Dr Suresh Rao, head of department, Critical care, Fortis Malar Hospital, says that the problem in India is linked to the lack of definitive guidelines until recently, He says, “In a country like the US, you have guidelines as to when and who can prescribe antibiotics. In India, however, we have general practitioners prescribing it indiscriminately. Lesser dose of antibiotics can make bacteria develop resistance. This when a patient is immune-compromised and becomes a problem while treating them. Simple antibiotics don’t work on the infection and we cannot administer higher antibiotics without carrying out a culture test. When we wait for the culture results, they tend to become sicker.” 

The lack of knowledge about the difference between virus and bacterial cause for common ailments and lax drug control measures make the case of antibiotic resistance stronger, says Dr S Elango, former director, Public Health and Preventive Medicine. “People use the same prescription given to them for a previous ailment, if the symptoms are similar. It could have been streptococcal the previous time and now pneumococcal; but they think it is the same cause. Moreover, healthcare providers do not specify the generic name and mention the brands. The pharmacist substitutes it for a cheaper or available drug that may or may not be effective. This is another reason for the resistance,” he says. According to him, there are existing rules barring the sale of these drugs over the counter. “Yet, over- the- counter sale of antibiotics continues across the country,” he adds. 

Dr Sridevi Anantharaman, General Medicine and Diabetologist, Apollo Speciality Hospital, Vanagaram, says in India, healthcare professionals go overboard, prescribing antibiotics even for children. “Administering the drug at a young age even for a common cold, and that too repeatedly make children develop resistance at a young age. In other cases, too, we need aggressive intervention only when the person has other co-morbidities like diabetes or heart issues,” she adds. 

Dr Sridevi says that there is an urgent need to educate patients about the use of antibiotics and come up with modules for them to understand when they need to go to a doctor and when they can deal with ailments on their own and not self-medicate. 

Dr Rao says that given the prevalence of resistance among patients (20 per cent), adhering to a antibiotics policy at hospitals can rein in the condition. “We follow it at Fortis and each time, we prescribe higher antibiotics, we have to specify why. But it is not enough if a few hospitals follow these procedures,” he says.