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Growing dependence on antibiotics and its effects on human body

Dr. Sunita Yadav
Wednesday, June 28, 2017, 08:00 Hrs  [IST]

Discovery of the first antibiotic in 1920’s had revolutionized the cure for bacterial infections and its benefits in subsequent treatment led to the discovery of different antibiotics.

Antibiotics are classified into two categories, namely, broad spectrum antibiotic and narrow spectrum antibiotic. Broad spectrum antibiotic is effective against a diverse range of bacteria, while narrow spectrum kills very specific bacteria. Wide use of antibiotics in the past several years have saved millions of lives. However, its overuse has developed antibiotic resistance in pathogens, which has acutely disrupted the ecology of human microbiome. According to recent research reports, India is faced with the death of nearly 60,000 newborns, every year due to antibiotic-resistant neonatal infections. With the rise in resistance, we are losing the potential to fight life-threatening diseases like TB, HIV, and Malaria. Additionally, in diseases like cancer and surgical procedures there is a decrease in effectiveness of antibiotics to treat acute infections.

In 2015, antibiotic-resistant pathogens were estimated to cause over 50,000 deaths one year in Europe and USA, where the worldwide projection was 10 million deaths per year by 2050. In 2010, India was the largest consumer of antibiotics. According to a recent report, this is an alarming sign for India, which has the distinction of being called one of the front-runners in terms of overuse of antibiotics.

There are changes in the rates of resistance of various antibiotics, as has been observed in past several years, against microbe species in India. Researchers have found that the increase of resistance to fluoroquinolones in Invasive Salmonella Typhi has gone up from 8% in 2008 to 28% in 2014 whereas the resistance level of two old antibiotics - ampicillin and cotrimoxazole are 5% and 4% respectively. They have also found 11% vancomycin resistant in Enterococcus faecium isolates. Other resistant infections like Acinetobacter baumannii where application of colistin is increasing have also shown a rise in resistance. Furthermore, there are troubles associated with Grampositive infections. Here, rates of resistance which are as high as 54.8% (ranging between 32% and 80%) have been noticed in clinical isolates of methicillin resistant staphylococcus aureus (MRSA).

According to Dr. Manyu Rishi, family physician, Medicine, “There should be protocols for antibiotic in clinics, hospitals and dispensaries. About 70% of India lives in rural and semi-urban areas and due to lack of proper medical facilities they have to approach local pharmacists and this leads to misuses of drugs”.

This is the time to kick start the appropriate usage of antibiotics against specific bacterial infection to secure the healthy future of our nation.
Benefits of antibiotics in treatment of bacterial infections
1.    Kills bacteria: Antibiotics kill the bacteria by stopping their multiplication and boost the immune system of the body. Doctors should prescribe antibiotics only against particular infections and specific types of bacteria.
2.    Skin diseases: Dermatologists recommend the use of antibiotics for skin infections and related diseases. Here, use of systematic and oral antibiotics may reduce the side effects.
3.    Reduces infections and protect your health: Antibiotics are used to treat various life-threatening infections. However, to ensure balance of harmful and useful bacteria probiotics may be advisable in the case.

Side effects of overuse of antibiotics
Harmful effect of overuse of antibiotics in infants or kids: Usually fever, glazed eyes and swollen glands are some of the common symptoms of illness in children. However, there are many illness caused by viruses that don’t require antibiotics. The usage of antibiotics in this condition wipes out healthy bacteria from the body. According to research, its inappropriate usage may increase the risk of autoimmune diseases and increases the risk of child obesity.

Effect on pregnancy:
There is a bidirectional role of pregnancy and the microbiome. Pregnancy effects the microbe’s composition, while they have a role in the health outcomes of the child and mother. There are changes that have been observed in the diversity of microbes which increases the dominance of Lactobacillus species, Clostridiales, Bacteroidales, and Actinomycetales. In case of pregnancy, 80% of medicine prescription include antibiotics and this affects the sensitive balance of maternal microbiome and fetal normal development. Its excessive utilization may affect the health of pregnant woman and increase the risk of asthma, epilepsy, and obesity.

Development of stomach problems like diarrhea, vomiting and nausea.
Increases the infection in mouth, vaginal (pain, itches and discharge) and intestinal infections.

Allergic reactions in skin, fever and breathing problems.
Development of resistant bacteria: Overuse of antibiotics results in the in responsiveness of bacteria against antibiotics.

Action needed to avoid overuse of antibiotics
Public awareness health camps to promote the use of improved water, food, cleanliness and sanitation facilities. Providing better hygiene, especially washing hands on a regular basis, use of alcohol disinfectant in case of patients and maintenance of cleanliness and hygiene inside the hospital with daily quality control.

Improving coverage for existing vaccines and adding new ones. Try to consult a doctor for new infections and don’t use the antibiotic prescribed in previous illness. Any new illness may be a new infection with different bacteria and hence, requires a change in dose. Through the Immunization of family and kids with vaccines like pertussis and pneumococcal disease vaccine, we can avoid most of the dangerous bacterial infections.
Moreover, research has proven that the pneumococcal vaccine helps in the prevention of antibiotic resistant in kids.

Right and rapid diagnostic can be of great help to reduce the overuse of antibiotics in patients.

Smart medicine
Avoid the use of antibiotics when it is not necessary for the illness. We have to create the awareness among common people that antibiotics kill bacteria not viruses which is the main cause of many illnesses, especially in kids. The usage of antibiotics in this scenario only kills useful bacteria in the system which may be responsible for the rise of far severe bacterial infections.

There are some symptoms which may or may not require antibiotics like fever where 90% of fever/ flu or cold happens due to viral infections. However, fever which is caused by bacteria like strep throat and urinary tract infection does not always require the antibiotics. There are the symptoms like ear, eye and skin infections where we have to make an appropriate use of antibiotics after the right diagnosis.

Drug-free treatment
Use the drug according to the type of infection and severity of the conditions like in the case of an abscess, a doctor can drain the bacterial fluid from the body which may also reduce the antibiotic intake. In children, younger than 2 years of age, Pediatricians cannot wait to see severe symptoms as they have to start the treatment immediately. However, in adults one can wait for the diagnosis, especially if the symptoms are related with fever and flu.

Over usage of antibiotics and emerging resistant bacteria is a big global threat for the human population. There is immediate coordinated effort required in the direction of public awareness and appropriate usage of antibiotics to achieve the desired benefits for human population. Moreover, public health authority must take measures with the help of policy to stop the availability of inexpensive antibiotics over the counter.

(Author is head of quality control, Dalmia Medicare)


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