Group President, Group Managing Director & Editor In Chief: Dr.Shelly Ahmed

Tuesday, June 14, 2016

Antibiotic Resistance: How Soon Will Your Antibiotics Stop Working?


Medical science is undoubtedly one of the most important inventions in the history of mankind. In fact, it is an invention that has led to the discovery of various medicines and machines that have helped mankind live better and longer. But as they say every good thing comes at a price and antibiotic resistance is one such price that we may have already started paying for.

As per a report 'State of World Antibiotics 2015' conducted by the Centre for Disease Dynamics, Economics and Policy, New Delhi, India is counted as the leading consumer of antibiotics. Reports have also claimed that antibiotic resistance will kill 300 million people by 2050.

As time grows the treatments will become tougher and the number of medical casualties owing to the antibiotic resistance will increase by leap and bounds. If we fail to act today, our children will lose their line of defense against fatal bacteria.

What is antibiotic resistance?
Antibiotics are consumed in order to check the growth of bacteria that cause various infections and illnesses in the human body. If these bacteria continue to grow despite the antibiotic consumption, the stage is referred to as antibiotic resistance. Increasing cases of drug resistant TB demarcate how rapidly the resistance is spreading. Dr Supradip Ghosh, Additional Director, Department of Critical Care, Fortis says "The more harmful bacteria are exposed to antibiotics, more they tend to resist the same."

What causes antibiotic resistance?
Evolution and change is the law of the nature leads to antibiotic resistance. Like humans, nature does not discriminate among its creations and thus provides equal fighting chances to all. Humans evolved over a span of millions of years and so did other microscopic organisms. Did you know, bacteria and various other microorganisms were there on this planet even before humans came into being? Understandably so, bacteria is better adept to evolving to the conditions around them. As per World Health Organisation (WHO), "The evolution of resistant strains is a natural phenomenon that occurs when microorganisms replicate themselves erroneously or when resistant traits are exchanged between them." Like us humans, the organisms are merely responding and fighting back for their survival.

Anurag Roy, Business Unit Director, Asia-Pacific, Middle East and Africa at DSM Sinochem Pharmaceuticals, which advocates for sustainable antibiotics says, "Antimicrobial resistance (AMR) also called Antibiotic Resistance is a global threat today. AMR renders antibiotics ineffective, which means that they can no longer fight bacterial infections and ultimately become useless. Every year, AMR is responsible for the deaths of nearly 60,000 babies in India who are most vulnerable and unable to fight infections."

Why it needs to be addressed now?
For starters, antibiotic resistance will majorly affect the doctors' ability to treat people. It is very important for us to know that it takes decades of hard work and research for a antibiotic to be discovered and several more years to develop safe versions of the same. There is a strong possibility that most bacteria will become resistant before the new antibiotics are developed and made fit for human consumption.

Antibiotic resistance has the ability of transforming the simplest of treatments into complicated ones. It not only increases the costs involved in the treatments but also dramatically increases the death risk.

Antibiotic resistance has the power of transforming organ transplants into impossible jobs. Dr Ghosh says, "Our immunity becomes weak when we undergo organ transplant, and that is the best time for harmful bacteria to catch hold and cause serious damage."

As per WHO, "Patients with infections caused by drug-resistant bacteria are generally at increased risk of worse clinical outcomes and death, and consume more health-care resources than patients infected with the same bacteria that are not resistant." CDC states that two million people in the US alone get infected with bacteria that are resistant to antibiotics and around 23,000 people die because of these infections.

What aggravates the resistance?
There are numerous factors that aggravate antibiotic resistance. The one that majorly abets the situation, includes the misuse of antibiotics both by the patients and the doctors. Several medical watch dog agencies have shared guidelines stating correct ways of prescribing antibiotics but there have been instances where antibiotics are prescribed rampantly. Dr Ghosh adds, "Cold and cough infections are majorly caused by viruses yet antibiotics are used as prime lines of treatment."

As per DSM Sinochem Pharmaceuticals, "Big global manufacturers prefer to set up local units in India and China to bypass laws and regulations (due to lack of effective enforcement) and also sell their antibiotics at cheap prices. Producing antibiotics generates loads of waste in the form of water, air and solids. If these waste streams are not managed responsibly, the pollutants can end up in our environment and reach our bodies through air and water."

The easy availability of these antibiotics in countries like India is also a major contributor to the problem. People self prescribe and buy antibiotics without proper prescriptions. Not only that, even pharmacists prescribe antibiotics on their own without being qualified to do so.

Adding antibiotics in fodder is also a major factor for the sharp incline in the problem. Businesses involved in commercialised farming of animals add antibiotics to fodder in order to fasten the growth of animals in terms of weight and size. Lack of sanitation and proper nutrition also add to the problem of antibiotic resistance.

What can one do? - Dr. Monica Mahajan, Associate Director, Internal Medicine, Max Healthcare says, "The antibiotic dose is prescribed by the Doctor as per the disease and person's body weight, hence should not be self adjusted. It is important to complete the entire course and not stop it midway to avoid developing resistance."

- There should be no indication of using antibiotics for viral infections including cough and cold unless the doctor prescribes it for a bacterial infection on top of a viral flu.

- Certain antibiotics are not safe in pregnancy, kidney or epilepsy patients and are best avoided.

- If you are allergic to a particular antibiotic, avoid all drugs of that particular class. Carry a slip with the name of the medicine with you at all times and mention it to the Doctor prescribing the medication.

- A number of bacteria for community acquired infections like urine infection are becoming multi-drug resistant due to overuse and abuse of antibiotics. There are very few new molecules in the pipeline for newer antibiotics. Hence, we need to do our bit since we are facing the scenario of 'bad bugs, no drugs'.

- It is better to immunise using vaccine against preventable diseases.

- Food should be cooked properly as heat kills a lot of bacteria. This gets especially important for non-vegetarians as it is reported that poultry owners feed antibiotics to animals.
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