How many times have you come back from the doctor after being diagnosed with a ‘viral’ and have been armed with a prescription for an antibiotic? Chances are, it has happened often. You inevitably feel better after a week or so without realising that you would have recovered even without taking the antibiotic.
Reason: antibiotics treat only bacterial infections, not viral attacks.
The fallouts of such irrational use of drugs by medical practitioners and careless self-medication by patients are now coming home to roost — many germs are becoming resistant to these antibiotics.
‘‘In almost 90% cases of diarrhoea, for instance, the cause is viral and the patient will recover in a week. But the doctor faces patient pressure and may find it difficult to send him or her back without prescribing any drugs. The reluctance of patients to undergo pathological tests, habitual self-medication and subtle persuasion from pharma companies add to the problem,’’ says Dr C M Gulhati, editor, Monthly Index of Medical Specialities. Newer drugs to become costlier: Docs
Indiscriminate prescription of drugs and antibiotics by doctors and self-medication on part of patients has made germs immune to some drugs.
As a result, many common antibiotics no longer work. Says Gulhati, ‘‘Tetracyclines and erythromycin are some instances of drugs that no longer work because germs have become resistant to them. Anti-bacterial drug ciprofloxacin has also suffered the same fate.’’
While this is a major problem faced by countries around the world, the situation is particularly bad in India. In a few years, doctors predict, newer antibiotics will become more costly while the older ones will be rendered useless.
Doctors too are to blame for this situation. ‘‘Most practitioners are not familiar with rational drug use practices and are often forced to prescribe a slightly high-powered drug where even a simple one may work,’’ says Dr. Dharmaram Choudhary, senior consultant, BLK Super Speciality Hospital. ‘‘Diseases caused by pseudomonas which leads to hospital-based and urinary infections and those caused by staphylococcus which leads to abscesses and skin infections have become resistant to antibiotics,’’ he added.
The use of irrational drug combinations has also magnified the problem. These drugs work by grouping different types of medicines together. ‘‘A disease like diarrhoea may be caused by bacteria, viruses or amoeba or have a mixed origin. So a company starts selling a combination of drugs that work against all these agents — a four-in-one combo. While exposing a patient to greater side effects, they also make you resistant to bugs over a period of time,’’ says Dr Gulhati.
Antibiotics need to be prescribed depending on the grade of infection, its severity, duration and the patient’s age. ‘‘But in most cases, they are misused or used without any indications. That’s why drugs which used to work against a wide range of infections till some years back, don’t anymore,’’ says Dr. Arvinder Singh Soin of Medanta Medicity Hospital.
Some drugs (with their indications) which don’t work as well as before:
- Ciprofloxacin: Acute sinusitis, lower respiratory tract infections
- Tetracycline: Used in bacterial infections, typhus fever, upper respiratory infections, pneumonia
- Erythromycin: Pharyngitis, pneumonia, skin infections
- Chloromphenicol: Used in typhoid
- Septran: Used in acute exacerbation of chronic bronchitis, urinary tract infections