Weeding out unscrupulous use of antibiotics
It is alarming to note that the stool of healthy patients was found to have resistant organisms and a few (2%) had multidrug-resistant pathogens. This condition can lead to the same very pathogens becoming ‘ multidrug-resistant pathogens’ when exposed to even a single antibiotic if it was not required. In fact, this study is very similar to a study done by the author in patients coming to the hospital directly from the community (more often treated with Antibiotics which were unwarranted); where the author reported an alarming trend of resistant pathogen carriage in the gut. Needless to say, the WHO has recognized antibiotic resistance as 01 of the 10 global health threats in 2019.
Antibiotic abuse is the most important culprit in this case. The commonest ailment in the community is said to be a common cold, which almost always is caused by a viral infection. However, it is often seen that patients self-medicate and some doctors even prescribe antibiotics for the same, when it is definitely not required. These antibiotics are not any kind of quick cure or miracle pill that would root out the common cold. In fact, these very antibiotics are responsible for the resistance encountered among bugs making them “superbugs”.
Unscrupulous use of antibiotics is seen in the human health industry and animal husbandry, like poultry, for increasing produce, etc. These unwarranted antibiotics find their way through healthy gut and pick up resistant genes and finally find their way into groundwater leading to their rapid multiplication. This means that even if you are not one to take antibiotics unscrupulously, you are still getting exposed to multiple antibiotics by way of poultry and maybe sadly even water.
Checking this menace is very urgent, and the following few pointers may help. Imposing strict regulations in the production and sale of lower as well as higher antibiotics. Regulatory bodies have to step up inspection of animal and poultry units for picking up culprits indulging in antibiotic abuse. Use of media via television, internet by government bodies to educate lay public about the problems faced with inappropriate use of antibiotics. This also has to be a part of the curriculums of all forms of medicine practiced in this country (Allopathy and alternative medicines), so that all doctors and especially the quintessential “family physician” are aware of this right from the time he or she starts their practice. The digital healthcare system of healthcare delivery, which the Ministry of Health and Family Welfare has proposed is a good step forward, in this regard and will go a long way in identifying and bring to task healthcare workers and individuals indulging in this inappropriate behavior of abusing antibiotics. It would also help to have voluntary organizations with in-depth knowledge of this subject, to spread the know-how by means of roleplay, music, etc.
If drastic measures are not taken quickly the author shudders with the view thought that a small scratch on the knee or an upset tummy would kill!!!
Dr Sanjith Saseedharan, Head, Intensive Care Unit, SL Raheja Hospital-A Fortis Associate