Antibiotic Resistance

While some may argue that doctors or quacks are prescribing antibiotics frequently as they may be obliged by the pharmaceutical companies to do so, there may be a few other controllable and uncontrollable factors, especially in South Asia. In the low income strata, people may not be able to visit a quality physician with hefty fees who would prescribe a blood culture to rule out existence of any bacteria before arriving at a diagnosis and prescribing a relevant treatment. Instead, people may opt for quacks or general practitioners who may charge very minimal fees but do not advise any medical or interventional tests and prescribe a blanket broad spectrum antibiotic which would cover all the bacteria possible, if any! This doctor would also be prescribing a few generic, low-quality pain-killers and anti-pyretics to reduce fever or a steroid, sometimes even for free.

In most such cases, even the liberal antibiotic regimen being advised by these doctors is not followed properly, as patients discontinue the expensive daily antibiotic dose after 3 to 4 days, once the fever subsides or the associated symptoms are reduced. Interestingly, this is only due to the fact that the fever was probably due to allergic or viral causes and not bacterial ones! Regular liberal use of broad spectrum antibiotics for every other medical condition and discontinuation of a proper treatment protocol at will are very common aspects in the South Asian healthcare sector and are fundamentally responsible for Antibiotic Resistance.

The unofficial over-the-counter availability of antibiotics in almost all South Asian countries adds to the bleak scenario. A shopkeeper who may not have even seen the patient or a prescription, would give a few capsules or a full course of an antibiotic, on-demand, to a buyer. Some shopkeepers may sometimes be prescribing antibiotics themselves, while not even knowing that the root cause of the symptoms who may not even be there.

According to W.H.O., Antibiotic Resistance is one of the biggest threats to global health and can affect absolutely anyone. Every time an antibiotic is prescribed results in less effectiveness of the same antibiotic in future. Infections become harder to treat, resulting in longer hospital stays, higher medical costs and mortality.

There are a few key points which may be adopted to reduce overuse and misuse of antibiotics and thus, in the longer run, curtail the chances of Antibiotic Resistance. These include:

1) Use of antibiotics when prescribed only by certified healthcare professionals (HCP).
2) Never insist or pressurize your HCP to advise one.
3) Never share or use leftover antibiotics.
4) Do not stop an antibiotic course without your HCP advising you to do so.
5) If possible, it is better to identify the causative organism. This will help in prescribing a focused and targeted antibiotic pertinent to the need, rather than a broad spectrum antibiotic providing for blanket coverage of all organisms.

While these points may help in curtailing Antibiotic Resistance, it is the behavioural change in liberal prescribing and lifestyle changes that we need to adopt throughout the world as it can do wonders. Such change would certainly include cleanliness, hand-washing, hygiene maintenance, safe sex, vaccination and healthy food intake. Thorough hand-washing, consumption of boiled clean water, proper cooking of food and proper waste disposal management goes a long way in eradicating the chances of development of stronger bacteria and antibiotic resistance by nipping them in the bud!