The problem of resistance to antibiotics is acute and needs to be urgently controlled, otherwise there would be serious long-term health implications in the society, health experts in Goa said.
Goa State Epidemiologist Dr Utkarsh Betodkar said over-the-counter (OTC) sales of antibiotics without valid prescription should be strictly prohibited, while prescription audits should be done.
“Prescription auditing is an important tool to improve the quality of prescriptions, which in turn improves the quality of health care provided. It seeks to monitor, evaluate and if necessary, suggest modifications in the prescribing practices of medical practitioners. For example, a good percentage of OPD cases are of common flu. Antibiotics are prescribed in most of the cases, which is not required,” Dr Betodkar said.
He added that during COVID-19, antibiotics were prescribed by doctors even for mild cases.
“All these practices make the problem worse. Although all secondary and tertiary hospitals are doing culture sensitivity to see what kind of medicine will work best to treat an infection, but that is the final part, which comes only after resistance comes into play,” he said.
Citing an example of how severe is the problem, Dr Betodkar said that antibiotics don’t work in many patients having uncontrolled diabetes.
“This is a very unhealthy situation. Nowadays there aren’t many antibiotics which are coming into the market regularly. Lot of hospitals have their antibiotic policy and if these are put in place properly, this problem can be tackled. There’s one national programme which is going on in the country. Things have started, but more efforts are needed in order to check the antibiotic abuse,” the Goa State Epidemiologist said.
Dr Vikram Dalvi, a consultant Internal Medicine physician, said that whenever people get exposed to any antibiotic, the bacteria which are there in our body have tendency to develop resistance gradually against the antibiotic.
“Today everybody is getting exposed to antibiotics. There are patients who need antibiotics and can’t do without it. Patients having viral infection but still take antibiotics, which is unnecessary. A lot of antibiotic is used in poultry and cattle industry for maintaining the health of the animals and birds. Normally we have a lot of healthy bacteria in our intestine. But repeated exposure to antibiotics changes its complexion,” Dr Dalvi said.
Previously, it was only the doctors who were required to control the use of antibiotics. But now not only doctors, but also pharmacists should ensure that the sale of antibiotics without valid prescription is regulated.
“For example, Erythromycine and Augmentin are given over the counter without valid prescription. So, in my view this needs to be curtailed. The use of antibiotics in poultry and cattle industry is very rampant and has to be checked. Due to this overuse of antibiotics, we are getting drug resistant bacteria in our body,” he said.
Speaking about the long term impact of resistance to antibiotics, Dr Dalvi said any person developing drug resistance will not get cured easily.
“Due to this the finances of patients will get drained, families will suffer. There is going to be long term adverse impact on the entire society. Pathogens in marine ecology, as pointed out in the NIO study are bound to enter our food chain. Everybody without their knowledge will get exposed to antibiotics,” he said.
Once they get exposed, then they will naturally develop resistant gut bacteria present in the intestine.
“Many times the origin of our infection is from our own intestine. Previously, we used to see patients would get cured against infection without needing antibiotics. But now we see patients at OPDs showing signs of drug resistance in their body system despite not having any history of exposure to antibiotics. This happens only if you are unknowingly getting exposed to antibiotics. One of the reasons for that is consuming food products having certain pathogens in it, which cause drug resistance in our body,” Dr Dalvi said.
Dentist Dr Amit Patil said that while one reason for antibiotics resistance is OTC sales of medicines without prescriptions, the other problem is that patients don’t complete the course of the medicines prescribed by the doctor.
“Due to this there is drug resistance within the body. For example, when I give 500 mg Amoxicillin to patients, it may not work in some cases. Then we have to increase the dosage to 625 mg. In future it could become 1000 MG and this would mean various kinds of side effects for the patients. Patient awareness is very important one should not do all dose or reduce the dosage without consulting the doctor the main problem and solution both is proper education,” he said.
