Doctors alarmed at unethical patronisation of antibiotics

The findings come from the first multicentric point prevalence survey of antibiotic use at 20 national antimicrobial consumption network (Nacnet) sites, conducted by the National Centre for Disease Control (NCDC) under the Union health ministry.

Nacnet, comprising 35 tertiary-care institutes across India, has been monitoring antibiotic consumption for five years. The survey revealed that 72 per cent of patients, who were surveyed, received antibiotic prescriptions between November 2021 and April 2022.

The Union health ministry's report disclosed that 45 per cent of patients received antibiotics as part of treatment, while 55 per cent were given them as a preventive measure.

Dr Tomar, in his 2017 work, "Antimicrobial resistance: the next big pandemic", referred to India as the AMR (antimicrobial resistance) capital of the world. AMR ranks among the top ten public health threats, as acknowledged by the World Health Organisation (WHO).

A recent study found that a high number of patients in 20 major hospitals were receiving antibiotics and medications meant to combat bacterial infections. The survey indicated that 'watch' group antibiotics were prescribed more frequently (57 per cent) than 'access' group antibiotics (38 cent) at these sites.

According to the WHO, 'watch' antibiotics pose a higher risk of antimicrobial resistance and are commonly administered to the more sick patients in medical facilities, while the access group, which includes 48 antibiotics, are highlighted for their broader activity against a range of susceptible pathogens and lower resistance potential compared to other groups.

Health experts like Dr B. Madhurima, senior consultant general physician, emphasised the need for cautious prescription practices.

"People are more than eager to pop pills they see as an immediate remedy for their issues than to wait for results through tests, which are time-consuming and cost money. It's a general presumption that antibiotics are quick healers and don’t have major side-effects," she told Deccan Chronicle.

Infectious disease specialist Dr Ranga Reddy Burri said that it was time that hospitals practice good infection prevention practices and antimicrobial stewardship programmes on the rational use of antibiotics. He added that at least 50 per cent of antibiotics used in all multispecialty hospitals are from the reserve group, which are meant to be used as a last resort to treat severe infections caused by multidrug-resistant pathogens.

"The bigger issue right now is the problem of pan-drug resistance if this continues. It's time the state leadership works towards containing antimicrobial resistance. Only four states in the country have an AMR plan and Telangana is not one of them," he pointed out.

In a recent development, Atul Goel, director-general of health services, mandated doctors to mention the diagnosis of patients before prescribing antibiotics. "It's the right of every patient to be informed of their diagnosis. They should ask their healthcare provider for it. Next, don't self-diagnose and self-treat; see a doctor. Never demand an antibiotic, be proactive and ask about alternatives," Dr Burri said.