GUNTUR: Akhil (name changed), a diabetic patient, met with an accident. When he was brought to the Government General Hospital (GGH), Guntur, the doctors had to perform a surgery to treat his injured muscle. While treating him, the doctors realised that he was resistant to 0ver 60 percent of the medicines given to diabetic patients. This made his recovery strenuous.
The main reason, according to doctors, was misuse or over-use of antibiotics. The major driver for antibiotic resistance is overuse of antibiotics, which exert unnatural selective pressure on bacteria, and leads to development of Antimicrobial Resistance (AMR). AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death.
According to WHO, a study indicated that between 2000 and 2015, antibiotic consumption increased by 103 percent, from 3.2 to 6.5 billion DDDs (defined daily doses). The easy access to pharmaceutical stores, informal dispensers and use of over-the counter-drugs can be said as major reasons for this. Speaking to TNIE, Dr Chukka Ratna Manmohan of general medicine wing at Guntur GGH said misuse of antibiotics refers to consuming antibiotics without medical advice, re-using old prescriptions, not completing the prescribed course or shortening treatment duration, taking less than the prescribed dose or failing to comply with the right frequency.
The Drugs and Cosmetics Act, 1940, and Rule 65 of Drugs and Cosmetic Rules, 1945, list the drugs which cannot be purchased without the prescription of a doctor. Despite having strict rules, pharmacists are selling high doses of antibiotics and medicines mentioned in Schedule H and H1 of the Act, to gain profits. While antibiotics have to be used judiciously, it is often not the case in both rural and urban areas where untrained medical practitioners treat patients.
This will lead to the use of ‘Over-The-Counter’ (OTC) or nonprescription medicine. The reason for increased use OTC drugs is the economic conditions of low and middle-class people who can’t afford doctor’s fees. The reluctance of people to go to hospitals for minor health issues is another reason. Now-a-days, several people will search for suitable medicines on the internet and get them from a nearby medical store. K Raghuram, a pharmacist in Guntur, says that most of the patients who come for self-medication straightaway ask for antibiotics.
“If we don’t give them, they will start arguing. And sometimes people come to buy medicines with an old prescription, and when others ask to give tablets for cold, cough, fever, respiratory ailments, or infections, we give a course for two days and suggest them to visit a doctor if they return seeking continuation of the course,” he added. While the overuse of antibiotics has been alarming in the past couple of decades, the issue has come to the forefront again during the Covid-19 pandemic.
Several patients were found to have developed resistance to many antibiotics, due to which the doctors had to prescribe high doses of antibiotics, which in turn will have severe side effects in the long run. During the first wave of the Covid pandemic, antibiotics usage was increased by over 30 percent. Dr Manmohan explains that, during the first wave, the world was very doubtful and panicked about a particular process of treatment.
So high doses of antibiotics were used to save patients’ lives. He emphasises that, if the situation continues like this, the human body will become resistant to several antibiotics and the condition will be out of hand after 20 or 30 years. The doctors say overuse of antibiotics is like inviting unwanted diseases. The solution for this burning problem is educating people and increasing awareness among them, opines Dr Manmohan.
At the same time, developing the government medical health centres and providing medicines to people will prevent them from going directly to dispensaries, he added. A DMHO official, who doesn’t want to be named, said as t0he government health centres, including PHCs, and UPHCs, were in bad condition. But now the health centres were revamped. Doctors are available at all times and medicines are distributed to the patients for free. He urged people to visit the nearby health centres for any health issues.
Use it judiciously
Major reason for antibiotic resistance is overuse or misuses of antibiotics
If the situation continues like this, the human body will become resistant to several antibiotics and the condition will be out of hand after 20 or 30 years, doctors say
30% increase in usage of antibiotics during the first wave of Covid
103% rise in antibiot ic co nsumpt ion, ie, from 3.2 billion DDDs to 6.5 billion DDDs
Use of ‘Over-The-Counter’ (OTC) or nonprescription medicine is dangerous, docs say
People should visit a doctor for any health issues and avoid self medication