February 04, 2019

#MedicalMondays: Antibiotic resistance

Today, on the first Monday of the #MedicalMondays segment, I am going to address a matrer of growing concern in the field of medicine all over the world, and lately in India as well...antibiotic resistance.


India has seen a rampant rise in the use of antibiotics, over the last few years.
My house-help, a 28 year old female, often insists I prescribe her antibiotics, even for a minor cold or cough and is disappointed when I refuse to do so. In fact, why just her? My friends and relatives have also, in the past, been guilty of doing the same.
Sometimes, I myself, have been tempted to pop in an antibiotic without confirming the accurate pathology of a viral flu.

Ergo, the need to shine some light upon this topic of growing concern...

What is antibiotic resistance?
Antibiotics are a group of drugs that are capable of destroying or inhibiting the growth of bacteria.
They are used to treat bacterial infections like pneumonia, TB, ear/throat infections, urinary tract infection etc.
Bacteria are constantly evolving inside the human body. Repeated use of an antibiotics causes these bacteria to gradually withstand the curative effect of that antibiotic, thus allowing the thriving bacteria to mutate and multiply in large numbers. Thus the antibiotic, which was once effective, is now ineffective and unable to fight the infection.

Why is it that we have become an antibiotic-obsessed nation? 
It is a common misconception that stronger the medicine faster the patient improves. And what ‘strong’er drug than an antibiotics to hasten the recovery from a niggling cold, or untimely flu, thinks the common man.
However, what is often not realised is that the effectiveness of any kind of treatment does not depend on the strength or dosage of the drug but on its appropriateness with reference to the ailment.

Let’s discuss this in a little detail...

Causes of Antibiotic Resistance :

  • Misuse and overuse of antibiotics.
  • Over prescribing of antibiotics
  • Abrupt stoppage of antibiotic treatment.
  • Lack of proper hygiene and sanitation.
  • Poor infection control.
  • Indiscriminate use of antibiotics in live stock
  • Inefficient and slow lab tests. 


Misuse/overuse by patients:
Antibiotics are often taken for viral flu and common cold (self-medication).
Around 80% of common colds are viral in nature, and so an antibiotic in such cases would be ineffective.
It must be remembered that antibiotics fight only against bacterial infections and are useless against viruses.

Recommendations of antibiotics from relatives who mean well, self-proclaimed doctors, or the Internet should be discouraged. Consult a trusted medical professional for a prescription instead.

Misuse/overuse may cause the antibiotic to be ineffective in the future and hence should be avoided.

Another cause of antibiotic resistance is noncompliance on the part of the patient. 
Abrupt stoppage of antibiotic course on cessation of symptoms has been observed in patients. This kills the susceptible bacteria, allowing the resistant bacteria to mutate and give rise to the resultant increase in an antibiotic-resistant strain.
Hence when prescribed a course of antibiotic, it becomes important to complete the entire course.

Antibiotics are largely used as growth supplements in livestock to improve health of the animals and produce a larger yield and high quality animal products.
The antibiotic-resistant bacteria produced in the gut of these animals are then transmitted to humans through the food chain.
Also, 90% of antibiotics administered to livestock are excreted through their urine and feces into the soil, and act as fertilizers for plant produce; another means of entering the food chain.

Prevention:

  • Do not demand antibiotics from your doctor. Also do not share antibiotics with family members without prescription, or save prescribed antibiotics to use for a later date.
  • If you are adviced antibiotics by your doctor, take them as prescribed. Do not discontinue treatment until the course is complete. 
  • Maintain sanitation and hygiene. Wash your hands. Stay as clean and bacteria free as possible.
  • Embrace a healthy lifestyle. Eat healthy. Exercise regularly. This will keep you away from infections. 
  • Keep a chart/record for vaccinations and take them as per schedule.
  • Spread information about resistance and explain the dangers of inappropriate use of antibiotics among family members and friends.

The problem is global. But with judicious use and controlled management, we can prevent ourselves from becoming an antibiotic hazard.

Remember: when incorrect or in excess, even medicine turns into toxin. 

See you Next Monday...
Until then, stay aware, stay healthy!


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Disclaimer: Self-medication, with little/no prior knowledge of medicine may be harmful. ‘Medical Mondays’ aims to mainly create more awareness on issues pertaining to health and well being. However, the needs of every patient are different, and an online transfer of information has its own limitations. So please confirm with your consulting physician before attempting any drastic measure. 


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