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Antibiotics Abuse In India

 Antibiotics are life-saving drugs. However, the Unchecked use of antibiotics causes bacteria to develop mutations that resist the effects of antibiotics. Antibiotic resistance causes more diseases and deaths and more extended hospital stays, and higher medical costs. The inappropriate prescription and use of antibiotics have become a significant cause of concern worldwide. The World Health Organization regards antimicrobial resistance (AMR), of which antibiotic resistance is a subset, to be a worldwide health emergency. Every year, AMR kills about 700k individuals, where 200k individuals die because of Multidrug-resistant tuberculosis (MDR). 

While the problem is global, nowhere is it more acute than in India. A lack of public health infrastructure, a high illness burden, and cheap, uncontrolled drug sales have created ideal circumstances for a rapid rise in antibiotic-resistant diseases. India is the world's largest user of antibiotics, thanks mainly to its enormous population, with consumption rising by 103 percent between 2000 and 2015, the most among all low-to-middle-income countries (LMICs). As deduced by the State of the World's Antibiotics 2021 study, between 2010 and 2020, India's human antibiotic consumption surged by 30% per capita. 

Looking at the extreme figures, one must ponder the causes behind India's widespread antibiotic abuse. The primary reason behind the antibiotic abuse is a lack of customer awareness and understanding about their use. They frequently do not understand how to use antibiotics correctly and have numerous misunderstandings regarding them. Customers sometimes see antibiotics as a "quick remedy" for all diseases, providing them with rapid relief from pain or suffering. At times they consume it as a "supplementary energy tablet," Oblivious to the potential adverse effects.

Moreover, most consumers are unaware of existing regulations governing the sale and purchase of antibiotics classified as prescription drugs (Schedule H and H1). Furthermore, these minor restrictions on antibiotic purchase can be readily circumvented by pharmacies, which clerks generally manage with little medical understanding and a financial motive. Antibiotics may be purchased without a prescription over-the-counter in pharmacies in India.

The majority of customers are even unaware of the fact that antibiotics should only be obtained with a current/valid doctor's written prescription.

In addition, self-medication by many consumers, whether via reliance on previous prescriptions or contacting family or friends, is a primary source of OTC purchase of antibiotics. Consumers re-use their doctor's earlier prescriptions and start seeking antibiotics on their own, especially if they have identical symptoms to the ones for which the medication was issued in the first place. All this has resulted in a rapid rise in antibiotic-resistant diseases in India.

Furthermore, in the next few years, it is highly speculated that India will see a further increase in antibiotic resistance, fueled by the misuse of solid medicines to treat suspected bacterial infections in Covid-19 patients. 

Patients in India, even those with minor cases of Covid-19, have been given powerful antibiotics like azithromycin and doxycycline during therapy, despite clinical research showing that these antibiotics are ineffective in treating the condition. The majority of antibiotics administered to the patients were from the "watch" and "reserve" categories of the WHO's AWaRe antibiotic categorization system, suggesting that these medicines be used only as a last option.

According to research published on May 24 in the journal “Infection And Drug Resistance'' by a group of Indian scientists and clinicians, it was deduced that only approximately 17% of the prescriptions came from the "access" category, which includes antibiotics for first- or second-line therapy. Hence, such inappropriate usage of antibiotics may be "adding gasoline to the fire of the already worrying antimicrobial resistance levels in India."

Antibiotics are still being administered for ordinary colds and flu when they aren't even needed. Clinicians point out that powerful medicines like the newer-generation Cephalosporin are routinely sold for no apparent cause.

The truth is that more has to be done to avoid a biological calamity. Every time we use an antibiotic, we give a few 'super bug' germs a chance to flourish. Anyone who takes antibiotics and then abruptly stops taking them without finishing the course is also aiding bacterial strains in developing resistance. Moreover, if the abuse of antibiotics continues, the severity and frequency of drug-resistant illnesses would only grow, and that might result in 10 million fatalities each year by 2050(WHO study)

Hence, governments throughout the world must start enacting more robust measures to limit antibiotic misuse. There's a growing need for several advanced studies to be conducted in ayurvedic and homeopathic medicines to find antibiotics alternatives. India being the home to the study of Ayurveda and homeopathy, can deduce and make people aware of the home remedies and the cures that would be natural and less harmful. Apart from this, it is mandatory on the part of Indian medical institutions or government to take the matter on its hands and make people aware about the adequate use of antibiotics to prevent its misuse in common diseases; with strict implementation of laws that should be able to prevent the sale of antibiotics without prescription.

Sources: 

https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1885-642X2021000100013&lang=pt 

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001974 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4775002/ 

https://www.dovepress.com/secondary-infections-in-hospitalized-covid-19-patients-indian-experien-peer-reviewed-fulltext-article-IDR

https://cddep.org/publications/the-state-of-the-worlds-antibiotic-in-2021/#:~:text=Global%20antibiotic%20consumption%20in%20humans,percent%20between%202017%20and%202030

 

Submitted by Drishti