Antibiotic resistance has been termed as the biggest public health challenge that the world faces, yet the misuse of these crucial medicines continues. Longer hospital stay, increased cost of treatment and negative outcomes are the direct results of the growing drug resistance. The Hindu speaks to Dr. Camilla Rodrigues, one of the city’s leading microbiologists on what is going wrong on the ground.
What are the challenges when it comes to treating resistant bacteria?
Take the basic example of common urinary tract infections. Now when we get a case of recurrent UTI, we are sure that oral antibiotics will not work and that we have to use intravenous medication. The threshold for resistance is coming up and this is a telltale sign. One has to understand that the bugs are not going to sit back and die. They have to evolve. Multiple mechanisms are operational today in bugs. Bacteria have no qualms in sharing their DNA. They are promiscuous, constantly begging and borrowing DNA to survive.
What is the role of doctors in the growing challenge of antibiotic resistance?
From the community perspective, we need to well differentiate bacterial and viral infections because that’s where the antibiotics are being misused. When you have the flu, cough or a runny nose, its unlikely to be a bacterial infection. But the reason doctors give often is that we are preventing secondary infection. Then there are times when doctors give two drugs instead of one just because they don’t want to take a chance. I am really of the opinion that antibiotic prescriptions by non-allopathic doctors should stop. A lot of homoeopaths, unanis, and ayurvedas are prescribing antibiotics even when it is not their area of expertise. They possibly know how to treat infections from their perspective and they should stick to the same.
Low awareness about antibiotic resistance among the public is also a big problem….
There is definitely a need for more public awareness. When antibiotics are prescribed, people need to ask doctors if they really need it. Often, people simply go to a chemist and self prescribe antibiotics. Then there are chemists who will add to this with their own suggestions. This self-prescription and chemist prescription have to stop. Antibiotic resistance is like global warming. It is not perceived as an acute problem. Till you don’t own it, till you don’t believe that even you are contributing, it is not going to change.
Do medical associations and doctors’ bodies have a role to play?
They have a huge role. The common general physician is definitely going to listen to the Indian Medical Association. The doctors need to appraised and they need to keep getting continuous medical education at the GP level. For example, groups like the Indian Academy of Paediatrics are doing great work in terms of antibiotics stewardship. The IAP has an initiative called Problem Solving in Paediatric Infectious Diseases (PSPID) through which they put forward case studies, and present it to peers for diagnosis and history taking. This practice is a positive example but more needs to be done on the level of GP’s and adult physicians.
