Antibiotics have saved millions of lives, mainly of people suffering from tuberculosis, meningitis and other illnesses, since the treatment was introduced more than a century ago. Today, unless strict action is taken to curb the overuse and misuse of antibiotics, we could be heading towards a situation where these previously “curable” diseases may become “uncurable”.
In India, weak regulatory practices compound the problem, leading to complex challenges. Many upper respiratory tract infections, including colds, sore throats and even some ear infections, should not be treated with antibiotics, yet often still are. The unholy alliance between pharmaceutical companies and doctors resulting in over-prescription of antibiotics for ailments is very much evident.
Sumit Ray, vice-chairman, critical care medicine at Sri Ganga Ram hospital, says, “We are seeing more and more patients who have already been prescribed very strong antibiotics at primary or secondary level hospitals. This is leading to an increasing level of resistance to antibiotics in the community. This leads to a vicious cycle, where physicians at the primary and secondary levels have to go for higher antibiotics for even basic infections and we at the tertiary centers end up giving even higher (or the latest) generation antibiotics like carbapenems. Over exposure of these antibiotics have led to a situation in India where we are seeing increasing incidence of even carbapenem resistance. The worst is that there aren’t enough training and educational programs for doctors to learn to deal with such issues.”
Another factor contributing to the problem is treating healthy animals with antibiotics to boost production, leading to resistance. And via the food chain, this spreads to humans. India does not have any mechanisms to check the use of growth hormones administered to cattle to increase milk production.
Is our government listening? Apparently, yes. The Union health ministry in 2011 formalized a National policy for containment of antimicrobial resistance however, not much is known about the fate of the policy. One can only guess it to be similar to most other policies in our country which lack the tooth for effective implementation.
To create more awareness on this issue, a group of doctors formed the Indian Initiative for Management of Antibiotic Resistance ( IIMAR) to “promote prudent use of antibiotics so as to reduce the possibility of spread of antibiotic resistance.”
“The ignorance and callousness are at every level of the society – from care providers like doctors, to pharmacists, lawmakers, manufacturers and [even] the consumers.”
We should therefore make informed decisions for treating common ailments before submitting ourselves to antibiotics prescribed by doctors. Because, we are the ones who glean the benefits or suffer the consequences. Sensitizing the public to this problem, in a way could motivate political commitment to implement an effective policy.