‘One of the biggest mistakes during pandemic’: Doctors worry over injudicious antibiotic use in Covid patients

In the last two years, health experts have come to note warning signs of yet another potential epidemic. Especially amid the pandemic, doctors suggest that injudicious use of antibiotics to prevent other infections in Covid patients, have only increased concerns of what is known as antibiotic resistance.

What does antibiotic resistance mean?

In simple terms, antibiotic resistance is the ability of bacteria and other germs to resist the effect of antibiotics they were once sensitive to. “According to WHO, Antimicrobial Resistance or AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death. So these microbes become resistant to one or more classes of antimicrobial agents, leading to failure of medication. Having these kinds of resistant bacteria or viruses in the community and health care facilities, especially ICU, is posing a risk (for sick patients) of negative outcomes in treatments,” Dr Mahesh M Lakhe, consultant – internal medicine & infectious diseases, Columbia Asia Hospital, Pune, tells indianexpress.com.

Taking cognizance, in 2013, the Indian Council of Medical Research (ICMR) set up the Antimicrobial Resistance Surveillance & Research Network (AMRSN) to enable the compilation of data on six pathogenic groups on antimicrobial resistance. Following extensive surveillance conducted nationwide, Antimicrobial Stewardship Programs were initiated to improve antibiotic use in the hospitals.

The situation, however, worsened amid Covid with doctors attributing the increased risk of antibiotic resistance to unscrupulous use of “high-end broad spectrum” antibiotics. “During Covid, serious patients developed secondary bacterial infections for which high-end antibiotics were used sometimes for a prolonged period leading to the development of resistance,” says Dr Suranjit Chatterjee, senior consultant, Internal Medicine, Indraprastha Apollo Hospitals, New Delhi.

“Use of antibiotics as a substitute to hospital infection prevention and control practices may have been one of the biggest mistakes during this pandemic,” adds Dr Lakhe.

Self-medication comes with a lot of risks. (Source: pixabay)

How self-medication contributes to antibiotic resistance

While becoming resistant, the bacteria is able to grow inside the body and increase infection. “In some cases, due to resistance, it can be impossible to treat the disease,” states Dr Chatterjee. This then can lead to prolonged hospitalisation and increased cost of treatment apart from putting one’s life in danger, adds Dr Praveen Gupta, director, Neurology, Fortis Memorial Research Institute, Gurugram.

“The available antibiotics are failing to kill these resistant organisms, and there is a dearth of new antibiotics eliminate the threat. This is partly a man-made problem,” Dr Lakhe remarks.

In fact, all of us are partly responsible when it comes to exploiting the risks. Remember the times when you pop a medicine bought off the counter for even a slight discomfort in the body? It is this common practice of self-medication that is further contributing to antibiotic resistance.

Self-medication can be “dangerous”, Dr Chatterjee warns. “With the slightest fever or cough, people have a tendency of taking medicines without consulting a doctor, by the time they reach out for a consultation, the disease may reach an advanced stage and get difficult to treat. Further, if the disease is communicable, it transmits to other people too.” According to him, here are the risks of self-medication:

*Incorrect diagnosis of the illness and incorrect process of therapy
*Failure to recognize pharmacological risks resulting in severe adverse reactions
*Failure to seek proper and prompt medical advice
*Duplicate medication which may lead to harmful drug interaction
*Inadequate or excessive dosage
*Risk of dependence and abuse
*Food and drug interaction
*Psychological effects due to incorrect diagnosis
*Inaccuracy of online symptom checkers

Antibiotic resistance is one of the elementary risks of self-medication, asserts Dr Gupta. “If you are popping Metrogyl or Augmentin everytime you have a symptom, bacteria will gradually become resistant to these antibiotics.”

How can antibiotic resistance be averted?

Antimicrobial stewardship and avoiding self-medication is the first step, says Dr Lakhe. This means the one should only rely on antibiotics prescribed by a doctor.

“Antibiotics should be used judiciously after identifying the actual cause of your infection. Instead of broad-spectrum antibiotics, directed, targetted doses should be used against specific pathogens. And when the infection is healed, the antibiotic should be quickly deescalated or reduced to safeguard antibiotics,” Dr Gupta advises.

Apart from this, one should try to follow a healthy lifestyle to prevent infections and thereby the spread of resistant bacteria, suggests Dr Chatterjee.