How over-the-counter antibiotics can threaten your health

Each year, drug-resistant infections kill around 7,00,000 people worldwide.

With the growth of antibiotic resistance complicating treatments for several diseases in India, we might reach a stage where common infections become incurable. Antibiotic resistance is a global threat to health and is part of a bigger problem called antimicrobial resistance (AMR).

AMR refers to the ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics and antivirals) from working against it. As a result, standard treatments become ineffective, infections persist and may spread to others, according to the World Health Organization (WHO).

Each year, drug-resistant infections kill around 7,00,000 people worldwide, and by 2050, this figure could increase to 10 million, according to an estimate. A World Bank report analysing the economic threats of AMR also suggests a decline of 3.8% of world’s annual GDP by 2050. In India, the problem of antibiotic resistance is even more crucial as the country bears a huge burden of infectious disease.

With easy availability of cheaply priced antibiotics over-the-counter, there is growing antibiotic use. (Shuttertock)

“The tropical wet and dry climate of India provides suitable conditions for proliferation of bacterial disease. India bears one of the highest burdens of bacterial infections,” says Rajeshwari Sinha of Centre for Science and Environment (CSE), a New Delhi-based research organisation. “This, along with largely unsanitary conditions, limited infection prevention and control, poor environmental regulations and practice, and inadequate health systems allow for the high prevalence of infectious diseases,” Sinha added.

With easy availability of cheaply priced antibiotics over-the-counter, there is growing antibiotic use. The result of such overuse, and often misuse, of drugs is antibiotic resistance. “‘Bad bugs, no drugs’ is no longer a mere slogan. The nightmare is turning into a reality. There is a surge in patients with multidrug resistant bacteria both on outpatient and inpatient basis,” said Monica Mahajan, associate director, Internal Medicine, Max Healthcare.

Besides urinary tract infections, antibiotic resistance is making it difficult to treat ICU (intensive care unit) infections and central lung infections, according to Rajesh Chawla of Indraprastha Apollo Hospital in New Delhi. Both therapeutic and non-therapeutic use of antibiotics in poultry and other animals are also contributing to the growing problem of antibiotic resistance, according to the experts.

Giving low doses of antibiotics routinely to animals mostly though feed, to fatten it in less time and less feed is a common practice. According to Supradip Ghosh of Fortis Escorts Hospital in Faridabad, Haryana, other factors driving antibiotic resistance in India include lack of awareness among both medical professionals and general public about the importance of preserving antibiotics.

A CSE study earlier this week revealed that while popular fast food multinationals made specific commitments to eliminate antibiotic misuse in chicken supply chains in developed countries, they have not taken such steps in India. The report accused these global giant of adopting “double standards”.

To address the issue, a Strategic National Action Plan (NAP) on AMR, led by the Ministry of Health and family Welfare and supported by the WHO, was released in April 2017. “While the NAP is ambitious and comprehensive, its thorough implementation will be a challenge,” Sinha said.

“At an individual level, we have to create awareness and stop self-medicating ourselves. Antibiotics can have side effects. Chemists should dispense medication only after ensuring a proper prescription and stamp the prescription mentioning the date and quantity dispensed. Increasing costs to discourage use will not work,” Mahajan said.