A recent study conducted by the BYL Nair Charitable Hospital of
the BMC in collaboration with the World Heath Organisation has
shown that resistance to antibiotics is growing alarmingly in the
community residing in the central Mumbai area. The report confirms
the growing alarm in the medical profession to the rising spectre
of antibiotic resistance a phenomenon in which common germs
that cause diseases like diarrhoea, urinary infection, typhoid and
TB refuse to be controlled and/or get exterminated when confronted
with antibiotics.The phenomenon has serious ramifications for
consumers at large. People who suffer from the diseases mentioned
above could face dire consequences, including death, if the
infection were to carry on unabated. Hospital beds and clinical
facilities would be under stress if faced with the need to test
every one with an infection.
To a community already screaming about the burgeoning costs of
medicare, this will add to the burden of increased hospitalisation,
investigations and costlier higher-grade antibiotics to treat what
were believed to be easily curable diseases. The occurrence of
Multi-Drug Resistant Tuberculosis is an example of this conundrum,
as several have succumbed to the disease which was believed to be
on the verge of extermination.Several causes have been cited for
the rise in the resistance of bacteria to antibiotics. One common
element is the gross abuse of antibiotics at every stage of its use
in the community. Patients who approach doctors have no time to
waste and insist upon their physicians to prescribe the strongest
possible medicine so that they can go back to their normal duties
the very next day. Acting under this pressure and in gross
violation of scientific norms, doctors then prescribe the
`strongest antibiotic, unaware or indifferent to the fact that the
antibiotic may or may not be useful for the condition which the
patient suffers from. For example, it has been proved beyond all
reasonable doubt that most coughs and colds occur due to viruses,
which never respond to antibiotic therapy.
Similarly, diarrhoea in children almost always never calls for an
antibiotic. Inspite of this, a very large percentage of persons
with these diseases are routinely subjected to antibiotic therapy,
where the side-effects of the antibiotics manifest themselves, but
there is not the remotest improvement of the patients condition
because of the antibiotic.A further aggravating factor in
antibiotic misuse is the rampant dispensing of antibiotics by
chemists directly to patients who report to them with various
illnesses. Clearly and unambiguously against the law, with an
inefficient enforcing mechanism in place, such indiscriminate acts
are never checked. Patients aggravate this situation by resorting
to self-medication. A previous prescription for a similar set of
symptoms, or medicines left over from a previous ailment lead to
irrational intake of antibiotics which cause further damage to the
system.The problem with antibiotic abuse is that when used
indiscriminately, antibiotics are set loose into the environment,
giving bacteria a chance to their exposure in `bacteria friendly
atmospheres.
Following the principle of survival of the fittest, bacteria then
learn to detoxify these antibiotics by various systems of
self-defence. The result: when a patient gets afflicted by a
disease which the bacteria causes, the antibiotic is literally
`useless which may often be detected after a prolonged period of
its use leading to greater adverse effects of the disease on the
human body, and ultimately leading to the use of stronger and more
costly antibiotics.Bacteria are nullifying the effects and efficacy
of antibiotics at a rate faster than the world is producing newer
antibiotics to which these bacteria are susceptible. A day may not
be far when no antibiotic will work.