Imagine this. You or your loved one fall sick and the infection just refuses to clear up. Or you are admitted to the hospital for a minor surgery, but end up contracting an infection that refuses to go away. Eventually your doctor tells you that are infected by a superbug that is not responding to any of the known antibiotics. Do you think that this is an impossible scenario in today’s modern medicine world? Sadly no! This is a grim reality and India is smack in the middle of this phenomenon called “antibiotic resistance”.
India was the largest consumer of antibiotics in the world in 2010, as reported by an extensive global survey done by the prestigious Princeton University. Surprised? You should not be.
Indiscriminate use of and self-medicationwith antibiotics are rampant in India. We have easy access to some of the strongest antibiotics, even without prescriptions.
How many of us have just walked up to our local chemist and told them to give us an antibiotic for a cold that has been around for 4-5 days? Most of us do that. Most of us are unaware that antibiotics are only effective against bacteria and not virus. The common cold is actually a viral infection and an antibiotic cannot clear it up. A common cold will clear up by itself in a few days (without any treatment), a fact not many of us know. Another common example of routine overuse of antibiotics as per the Princeton University report is for treating dengue in India. Again, dengue is caused by a virus and so antibiotics cannot cure dengue.
Is antibiotic overuse the only factor responsible for this?
No. Antibiotics are extensively used in animals such as cows and chicken. In fact, they are routinely given to animals as part of their feeds to prevent diseases and to fatten them up.Poor hygiene and sanitation has also helped push resistant germs
Poor hygiene and sanitation has also helped push resistant germs in to our drains and sewers and not-so surprisingly in to our drinking water. Adding fuel to fire is the unhindered dumping of antibiotic residues from drug manufacturing, livestock treatment and medical waste in to our waters.
What is the fallout of this?
This unrestrained use of antibiotics has led to mutation of bacteria who have cleverly evolved to resist most of the antibiotics that are commonly used. Thus, infections that could be easily treated before have now become difficult or even impossible to cure.
One famous example was the discovery of the gene called NDM-1 (New Delhi Metallo-beta-lactamase-1) in New Delhi, on common bacteria that made them resistant to all the known antibiotics. This gene not just made the treatment of infections difficult but also quickly moved from one bacterium to another leading to rapid spread of antibiotic resistance. What was alarming was that this gene was found not just on germs in hospitals in New Delhi but also found in germs in the local drinking water and in the upper reaches of the river Ganges, at Rishikesh and Haridwar, implying that the resistant bacteria were now spreading to the regular environment from the hospitals.
Doctors also have to use strong last resort antibiotics such as colistin and polymyxinB as these bacteria seem to be sensitive only to these drugs although these drugs are generally rarely used as they have severe side effects.
Are we all aware of the extent of this problem?
A survey done by the World Health Organisation (WHO) in 12 countries including India,pointed out that 76% of the people who took the survey in India had taken antibiotics in the past 6 months and 90% of these people got their antibiotics from a doctor or a nurse. Almost 75% believed that antibiotics can treat colds and flu. Only 58% knew that they have to stop taking antibiotics once the prescribed course is done. About 76% mistakenly believe that “Antibiotic resistance occurs when your body becomes resistant to antibiotics and they no longer work as well as before” whereas it is the bacteria that become antibiotic resistant and not humans.
What simple steps can you take to prevent this situation from worsening?
Practice good hygiene
- Wash your hands thoroughly and often with soap and water, so that diseases are prevented and you have no need for antibiotics
- Cook meat and meat products thoroughly and handle food hygienically so that food borne illnesses are prevented
Use antibiotics only when necessary
- It is important to remember that antibiotics must be used only for bacterial infections, in the proper dose for the correct amount of time
- Take antibiotics exactly as the doctor advises without skipping doses and completing the course even if you are feeling better
- Do not insist for antibiotics if your doctor thinks that you do not need them
- Do not self-medicate with antibiotics
- Do not share or use leftover antibiotics and take only those that have been prescribed for you. Taking wrong antibiotics will delay the correct treatment and allow the bacteria to multiply and become resistant
- The use of antibiotics in farm animals for anything other than actual treatment should be avoided
- To ensure that the currently available antibiotics continue to remain effective, their overall use should be drastically reduced
In hospitals and nursing homes, it is essential to ensure that antibiotics are used under strict guidelines and policies
Governments need to focus on removing uncontrolled access to antibiotics such as over the counter sale of antibiotics, improving sanitation, and cleaning up of water supplies
- This would probably ensure that people fall sick less often and thus would reduce the spread of resistant germs
Antibiotic resistance is a serious health problem in India. We have to follow some simple steps today to ensure that our children tomorrow still have antibiotics to fight infections. Don’t let the bacteria win this round!