Doctors call for rational use of antibiotics in India

Srinagar, July 22:
Medical professionals are calling for the rational use of antibiotics, highlighting a collective responsibility to combat antimicrobial resistance (AMR). Dr.ZahidMajeed, DM Critical Care, AIIMS-Delhi, now at a private hospital in Punjab, emphasized the critical role of antibiotics in treating infections, while pointing out their rampant misuse in agriculture, poultry, and community settings.
“In many rural areas, unqualified pharmacists dispense antibiotics indiscriminately, and self-medication is common. This widespread misuse contributes to AMR, which led to 1.27 million deaths globally in 2019, comparable to the impact of cancer and COVID-19. Without immediate action, AMR could push us back to a pre-antibiotic era where even minor infections were potentially fatal,” Dr.Majeed warned.
Doctors highlighted the pre-antibiotic era, where deaths from infections were frequent and often unavoidable. During the 1930s, common treatments included bourbon and placebos, reflecting limited medical options. The discovery of penicillin marked a revolutionary advancement, making it possible to cure infections effectively for the first time and dramatically improving patient outcomes.
Dr.Majeed stressed the importance of effective regulation to prevent misuse. “Similar to narcotics, antibiotics should be available only through a valid prescription. This ensures that antibiotics are used appropriately and helps curb the rise of resistance. Implementing such regulations helps control and monitor antibiotic use more effectively,” he said.
“Each unnecessary use of antibiotics reduces their effectiveness for everyone. Not every fever or minor infection requires powerful antibiotics like meropenem. Appropriate use is key to preserving the effectiveness of these drugs,” Dr.Majeed noted. Improper use of antibiotics contributes to drug-resistant infections, which are harder to treat and can lead to severe health complications.
Doctors emphasized that antibiotics should be prescribed based on clear indications. For instance, in non-biliary pancreatitis, antibiotic use might be more harmful than beneficial despite symptoms like fever. Hospitals should implement comprehensive antibiotic stewardship and monitoring programs. Infectious disease specialists play a crucial role in guiding appropriate use and preventing resistance.
Dr.Majeed pointed out that many healthcare professionals lack detailed knowledge about antibiotics, leading to reliance on guesswork for dosing, especially in patients with organ dysfunction. Utilizing trusted resources like the Sanford Guide or AIIMS Antibiotic App can greatly enhance prescribing practices.
Regarding the overuse of strong antibiotics, Dr.Majeed said broad-spectrum antibiotics should be reserved for cases where they are truly necessary. “Overuse, particularly in elective surgeries, can lead to unnecessary resistance. Adding extra antibiotics like metronidazole to a regimen that already includes strong antibiotics like piperacillin-tazobactam or meropenem is often unnecessary and does not improve outcomes,” he said.
“Not all Staphylococcus aureus infections are methicillin-resistant (MRSA). Vancomycin should be reserved for cases where MRSA is known to be a risk, as non-MRSA strains often respond better to other penicillin antibiotics. Avoid selecting high-power antibiotics based solely on signs such as elevated TLC count and fever. Consider actual risk factors for drug-resistant infections instead,” he advised.
In many communities, unqualified pharmacists sell antibiotics over-the-counter for minor conditions, leading to misuse. Kerala has taken a proactive approach by mandating that antibiotics be available only with a prescription, aiming to control antibiotic use and reduce misuse.
In January, the Union Health Ministry called on doctors in medical colleges to make it mandatory to mention reasons for prescribing antibiotics. The ministry also urged pharmacists to strictly follow the Drugs and Cosmetics Rules and refrain from selling antibiotics without a prescription from a qualified doctor.
“Antibiotics are a precious resource entrusted to us for the benefit of humanity. We must use them responsibly to maintain their effectiveness for future generations. Antibiotics are humanity’s trust, and we should use them wisely,” Dr.Majeed concluded.