Taking antibiotics for “slight ailments” in Kashmir is leading to a dangerous scenario where resistance to these drugs is fast growing among people, experts have warned.
Although antibiotics are prescription drugs, these are sold over-the-counter in Kashmir with no monitoring and adherence to the Drug Act that mandates that these be sold only with a prescription.“We have reported resistance to not just gram positive bacteria but also gram negative. We are sometimes left with no choice but to use the antibiotics that were considered toxic. Very soon, we will be left with no choice,” said DrParvezKaul, Head of the Pulmonary and Internal Medicine at SK Institute of Medical Sciences at Soura here.
A WHO survey report released last week warned against the consequences of growing antibiotic resistance world over. The survey found that ‘people are confused about this major threat to public health and do not understand how to prevent it from growing’.
Dr. Kaul warned it was not just the ‘wrong antibiotics’ that contribute to resistance but also the wrong way of taking them.
“Even doctors sometimes leave a course of antibiotics incomplete. Take it for two days, get well and stop using!” he said, adding, “Inadequate dosage and inadequate duration of antibiotic use is contributing to ‘smarter bugs’ that can be stopped by nothing.”
Health practitioners like DrKaul feel that the WHO report is just a confirmation of the ‘burgeoning problem’ in health systems in every country. They attribute the growing incidence and extent of antibiotic resistance to various factors, including lack of awareness about these drugs and their mode of action and consequences of misuse.
Dr Kaiser Ahmed, noted pediatrician and Head of Pediatrics at GB Pant Hospital here, said: “We have already burnt our fingers. And if we continue to use antibiotics the way we do, we will have nothing left as a treatment option.”
Although experts have called for greater awareness among masses about antibiotics, many feel that medical practitioners also need to be educated about the antibiotic characteristics, especially in the fast changing scenario of drug resistance.
An editorial published in CHEST (India edition Volume 6 #3 2015) states, ‘A Central Drugs Standard Control Organization (CDSCO) in 2012, estimated that 70-80 percent of antimicrobial drug prescriptions by healthcare providers were probably unnecessary.’ It further says that in 2007, CDSCO survey of market data had reported that 1800 out of 2000 brands of fixed dose antibiotic combinations had wrong or unnecessary compositions’.
The WHO survey findings have been publicized simultaneously with the WHO campaign – ‘Antibiotics: Handle with care’. The global initiative is aimed at improve understanding of the problem and change the way antibiotics are used.
Healthcare experts in Kashmir feel there is a dire need that healthcare policy makers in J&K start activities to educate masses. The primary awareness, doctors say, is that antibiotics are not always needed.
“We, as patients, have a tendency to pop an antibiotic at the slightest of body temperature rise. Fever is our friend sometimes,” Dr Kaiser said.
He said the body has its own mechanisms to fight infections and most fevers, “especially what I have seen in children I treat, are viral in nature and antibiotics have no effect on these.”
“There is a saying that if you give antibiotic in a viral fever, it will take one week to resolve, and if you do not, it will take seven days,” he said in a lighter vein, while appealing for judicious prescription of these drugs by doctors.
“Sometimes patients demand antibiotics and doctors are compelled by other factors to prescribe these. But we are, the way things are going, headed to create a scenario when people will die of a minor infection,” he said. “Pediatricians have a greater role to play, and they can change a lot by educating parents.”
Dr. Kaul said: “Inadequate dosage and inadequate duration of antibiotic use is contributing to ‘smarter bugs’ that can be stopped by nothing”.
Controller Drugs and Food, Nazir A Wani, was not available for comments on the mechanism, if any, that the DFCO has put in place to check the sale of prescription drugs in Kashmir.
It’s is a common practice for pharmacies to dispense drugs on demand and even prescribe these to people.
The CHEST editorial notes “it (anti-microbial resistance) has emerged as an even bigger problem in the developing nations where antibiotics are easily available over the counter, self prescribed and often not adequately taken.”
The editorial authored by DrParvez A Kaul and Nargis K Bali calls for more evaluation of the factors contributing to resistance.
The rampant use of antibiotics is elucidated by WHO survey that reported from India 76% of respondents having taken antibiotics within the past six months. 75% of the respondents believed, incorrectly though, that colds and flu could be treated with antibiotics.
