A few days ago, I found it hard to push away a heavy sense of despair, upon reading about a woman dying of an infection resistant 26 different antibiotics, in the US. The feeling worsened as I went on to read that she had returned to the US after a long stay & treatment in India and was infected with New Delhi Metallo-beta-lactamase 0r NDM (a multi drug resistant bacteria)
The problem of rampant and growing antibiotic resistance is well known. Yet most of us are all guilty at some point, as patients, of not completing a prescribed antibiotic course, because we feel better just a couple of days into the 5 or 7 day course. At other times, we self-medicate ourselves antibiotics when they are not really needed.
How does this all add up to the kind of awful antibiotic resistance in the news?
First, a few basics-we all have bacteria in our bodies – throat, nose, gut etc. When we pop-in antibiotics only for a few days, we kill the ‘sensitive to antibiotic bacteria,’ and leave behind the ‘resistance prone bacteria’. In other words, we inadvertently target only the weakest bacteria and exempt the stronger ones from being tamed by the antibiotics. These bacteria now have a full playing field to grow and prosper-a sharp contrast to their fate had the course of antibiotics had been completed. In that case, the resistance prone ones would also have been killed. Each time we take antibiotics unnecessarily, we give our inherent bacteria an inoculum against the bacteria and opportunities to develop resistance to it.
This real and growing risk of antibiotic resistance means a person could get very sick, or, in extreme cases, die of an infection as common as a Urinary Tract Infection (UTI). This is because antibiotic abuse has made our own bacteria resistant, or just as bad, the illness is from catching a resistant-bacteria infection. Remember also, no new antibiotics are being developed by pharmaceutical companies. We cannot afford any resistance.
Patients are not powerless to fight this. As someone who is ill, don’t begin to demand antibiotics of your doctor and certainly don’t pop in antibiotics just because the smug boy at the pharmacy tells you that you must. Ask questions about your prescription, if antibiotics are being given – why are they being used?
Remember this one thing: antibiotics fight bacteria, not viruses. Many cases of diarrhea or colds etc. are caused by viruses and do not need antibiotics. In these cases what you need are simpler measures and most importantly, waiting for the body to get rid of the virus naturally.
In our practice (Dr Rachna Kucheria, leading GP in New Delhi) we regularly make an agreement with the patient about a watch and wait plan- where we counsel them on the when to start antibiotics and how long they can safely do without them.
The WHO & Government bodies have put together plans, one of them is the Chennai Declaration-a roadmap developed at a joint meeting of medical societies in India, in Chennai in August 2012 to curb this serious problem.
In the meantime, as citizens, we can contribute by auditing our own consumption and prescription of antibiotics. And being aware of the contribution each one of us can make so that antibiotics continue to protect us, in the way that we have known them to.