Mumbai, India’s financial capital, is not just suffering with overcrowded streets and polluted air, it’s also fighting a growing health crisis: the misuse of antibiotics. A recent survey by Fortis Hospitals sheds light on alarming trends in the city, with self-medication, incomplete courses, and rampant antibiotic sharing becoming the norm. While antibiotics have saved millions of lives since their discovery, their misuse has now opened the door to an equally formidable enemy: antimicrobial resistance (AMR).

What Is Antimicrobial Resistance?
Antimicrobial resistance occurs when bacteria adapt and evolve to withstand the medicines designed to kill them. In simple terms, the once-powerful antibiotics lose their effectiveness, making infections harder to treat. This isn’t just a problem for individuals, it’s a looming public health crisis. Resistant bacteria can spread from person to person, leading to infections that are not only difficult to cure but also expensive and potentially fatal.

The Fortis Hospitals survey, which involved 4,511 residents aged 26 to 50 years, reveals a disturbing lack of awareness about the proper use of antibiotics. Let’s break down some of the key findings:

1. Minimal Medical Consultation: Only 43% of respondents sought a doctor’s advice before purchasing antibiotics. Over-the-counter availability and easy access have made antibiotics a household staple, often used without professional guidance.

2. Sharing Antibiotics: Over half of the participants admitted to sharing antibiotics with friends or family members experiencing similar symptoms, ignoring the critical fact that infections vary and so should treatments.

3. Incomplete Courses: A mere 39% completed their prescribed antibiotic courses. Most people stopped taking medication as soon as they felt better, giving bacteria the chance to survive and develop resistance.

4. Ignorance About Risks: A staggering 40% were unaware of the dangers of not completing their antibiotic regimen, while 71% couldn’t differentiate between bacterial and viral infections.

5. Pharmacist Role: Many pharmacists dispense antibiotics without prescriptions, further exacerbating the misuse. Without counselling on proper usage, patients are left vulnerable to the risks of inappropriate antibiotic consumption.

These behaviours are not only prevalent in Mumbai but also mirror a larger problem across India, making AMR a nationwide challenge.

Self-medication is deeply ingrained in Indian culture. Whether it’s a minor fever or a persistent cough, many individuals rely on advice from family or friends instead of consulting a doctor. The Fortis study highlights how this cultural tendency contributes to improper antibiotic use.

Dr. Farah Ingale, Director of Internal Medicine at Fortis Hiranandani Hospital Vashi, notes, “Antibiotics are often purchased without consulting a doctor because they are so easily accessible.” While this convenience might seem harmless, it’s a double-edged sword, leading to misuse and increasing the risk of AMR.

One of the most common misconceptions about antibiotics is their universal application. Many people mistakenly believe antibiotics are a cure-all, using them for illnesses like the common cold or flu, which are caused by viruses. Antibiotics, however, only target bacterial infections. Using them for viral illnesses is not just ineffective but also dangerous, as it promotes resistance.

Dr. Anita Mathew, Director of Internal Medicine at Fortis Mulund, explains, “Conditions like the flu are self-limiting and resolve on their own without the need for antibiotics.” Misusing antibiotics in such cases not only wastes resources but also endangers future treatment options for bacterial infections.

Vaccination is an often-overlooked solution in combating AMR. By preventing illnesses in the first place, vaccines reduce the need for antibiotics. Dr. Kirti Sabnis, an infectious disease specialist, emphasizes, “Vaccinations help people fall ill less frequently, thereby reducing antibiotic misuse.”

For those with comorbidities like diabetes, obesity, or liver disease, vaccines play an even more crucial role. Following a doctor’s recommendations for adult vaccinations can help prevent recurrent infections and lower the risk of antibiotic resistance.

Another widespread issue is the premature discontinuation of antibiotic courses. Once symptoms subside, many individuals feel there’s no need to continue the medication. However, stopping early allows surviving bacteria to mutate and develop resistance, rendering the antibiotic ineffective for future infections.

Dr. Sabnis warns, “Stopping antibiotics prematurely or using them unnecessarily leads to resistant bacteria, making future infections harder to treat.”

The problem of antibiotic resistance isn’t confined to humans, it also affects animals, plants, and the environment. Recognizing this interconnectedness, India has adopted a “One Health” approach to tackle AMR. This strategy promotes collaboration across various sectors, including human health, veterinary care, agriculture, and environmental management.

At a recent global conference on AMR in Jeddah, Saudi Arabia, Union Minister of State for Health and Family Welfare, Anupriya Singh Patel, highlighted the importance of this holistic approach. By addressing AMR at multiple levels, India aims to slow down the spread of resistance and preserve the effectiveness of existing antibiotics.

Pharmacists play a pivotal role in ensuring antibiotics are used responsibly. However, in India, antibiotics are often sold without prescriptions, contributing to their misuse. Dr. Ingale points out, “Without proper counselling, patients may use antibiotics inappropriately, thinking they are a quick fix for all infections.”

To mitigate this, stricter regulations are needed to prevent over-the-counter sales of antibiotics. Pharmacists should also be trained to educate consumers about the importance of completing prescribed courses and avoiding self-medication.

What Can Be Done to Curb Antibiotic Misuse?
Addressing antibiotic misuse requires a multi-pronged approach that includes awareness, education, and stricter regulations. Here are some actionable steps:

1. Educate the Public: Launch awareness campaigns to inform people about the dangers of antibiotic misuse, the difference between bacterial and viral infections, and the importance of completing prescribed courses.

2. Strengthen Regulations: Enforce stricter policies to control the sale of antibiotics without prescriptions. Pharmacists should be held accountable for dispensing antibiotics only with proper documentation.

3. Promote Vaccination: Highlight the role of vaccines in reducing the need for antibiotics. Encourage people, especially those with chronic conditions, to follow vaccination schedules.

4. Encourage Routine Check-Ups: Build a culture of preventive healthcare where people consult doctors regularly rather than relying on self-medication.

5. Empower Pharmacists: Train pharmacists to act as educators, guiding patients on proper antibiotic use and warning against incomplete courses or misuse.

6. Adopt the “One Health” Approach: Foster collaboration between human, animal, and environmental health sectors to tackle AMR comprehensively.

Why AMR Should Concern Everyone?
Antibiotic resistance doesn’t just affect those who misuse antibiotics, it’s a global threat. Resistant bacteria can spread through communities, hospitals, and even across borders. Infections that were once easily treated could become life-threatening, putting immense pressure on healthcare systems.

Mumbai’s survey findings are a wake-up call, not just for the city but for the entire nation. It’s time to move beyond convenience and prioritize responsible antibiotic use to safeguard public health.

The fight against antimicrobial resistance isn’t just the responsibility of doctors or pharmacists, it’s a collective effort that requires participation from every individual. By consulting doctors before using antibiotics, completing prescribed courses, and understanding the limits of these powerful drugs, we can all play a part in combating this crisis.

The message is clear: antibiotics are not magic bullets, and their misuse comes at a steep price. It’s time to change our habits and protect these life-saving medicines for future generations.

 Pic Credits : indiatoday