Expert views on health issues that matter

Over use of antibiotics

User profile imageDr. Daisy Dharmaraj


Many of us in India and some other countries with inadequate laws regarding selling drugs over the counter, immediately take an antibiotic when we fall sick with sore throat, fever or diarrhoea. Many doctors especially in private practice prescribe an antibiotic without a qualm. Patients also expect to be given one. Thousands of patients walk into a pharmacy and ask for treatment for common ailments, and the pharmacist easily sells unwarranted antibiotic,  in totally inadequate doses, even for treatment of a mild cold or a possibly viral infection.

Taking antibiotics frequently and in inadequate doses makes the bacteria resistant to antibiotics, i.e. they become powerful and cannot be killed by these antibiotics when as they cause illnesses in the future. These bacteria thrive and cause infections in many others, and can lead to serious illnesses and even  death.  There have been many warnings about this before by WHO but these are not heeded by many.

Now here is some very bad news- The first case of an infection that resists the antibiotic of last resort - colistin - has been detected in the US. The 48-year old woman from Pennsylvania recovered and the infection was vulnerable to other antibiotics. However, colistin is hugely symbolic as it is used when other drugs fail and officials warned the world was now reaching "the end of the road" for antibiotics. Colistin resistance was first discovered in China at the end of 2015. The study sparked concern around the world, and intensive testing rapidly discovered bugs that can resist colistin in Europe and Asia. Now data from the US has identified the first case in a patient, who had a urinary-tract infection, as well as colistin-resistant bacteria in farm animals and meat on supermarket shelves.

It is not clear where the infection came from as the patient had not travelled recently and colistin is not widely used in the US. Bleak future- The DNA that gives bacteria resistance to colistin - the mcr-1 gene - can spread rapidly between species. The concern is that colistin resistance will now hook-up with other forms of antibiotic resistance to create infections that cannot be treated.

Thomas Frieden, the director of the Centers for Disease Control and Prevention, said: "The more we look at drug resistance, the more concerned we are. "The medicine cabinet is empty for some patients, it is the end of the road for antibiotics unless we act urgently." However, Dr Beth Bell, also from the CDC, said in an interview: "Luckily haven't seen actual bacteria that are resistant to every single antibiotic." Commenting on the reports Dr Nasia Safdar, from the University of Wisconsin School of Medicine and Public Health, said: "The results are very concerning.
It is almost inevitable that more cases will  be resistant to  every single antibiotic."

Therefore whenever you are prescribed an antibiotic the next time, please ask  the basis for the prescription, and whether it is absolutely necessary. Do not buy antibiotics on your own from the pharmacy. If you have to take the antibiotic, take a full course of it- usually antibiotics are given for 5 to 7 days.

(with thanks to the Public Health in the Arab World (PHAW) discussion forum) Infection resist 'last antibiotic' in US

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