Ways To Prevent Antibiotic Abuse

Introduction

Antibiotic resistance is currently the new epidemic in India¹. It is one of the major growing concerns in the country because of an increasingly reckless use of antibiotics and self-medication methods being adopted by patients suffering from a mild illness. Due to the non-prescribed and incorrect dosage of medicine intake, the bacteria get resistant to medication, which then does not act when used to treat other major infections¹. 

Why Should We Be Worried?

At present, as many as five people suffer from kidney failure annually caused by either infection or heavy doses of antibiotics. Resistance among Indian children has reached alarming levels, with common drugs now failing to act on as many as 95% of pediatric patients. It is estimated that 2 million Indians will die by 2050 due to drug-resistance². 

Superbugs are strains of bacteria, viruses, parasites, and fungi that are resistant to most of the antibiotics and other medications commonly used to treat the infections they cause. 

Dr. Ashish Bajaj, M.B.B.S, M.D.

What Do You Need to Know About Antibiotic Resistance?

Antibiotic resistance occurs when bacteria or microbe manages to resist the effects of an antibiotic.² The microbes have such mutations in their cell synthesis that they are immune to the antibiotic effect. And what is more, they pass on this helpful mutation to their upcoming generations. Mind you; all this is happening inside a patient’s body. So now we have the same microbes which have grown more powerful against the antibiotic and have also grown in numbers. The problem comes to society when these stronger, resistant microbes find their way into a new patient². This new patient cannot be treated with regular medicines and his infection stays in the body for too long, damaging his/her health. 

Currently, several types of bacteria are becoming resistant to antibiotic treatment; these resistant bacteria multiply unhindered and lead to infections that are increasingly difficult to treat.³ Such antibiotic resistance is posing great danger to kids and adults who suffer from common ailments, which otherwise are easily treatable³. For instance, Tuberculosis mycobacterium is not only drug-resistant but is now multidrug-resistant and that is why it is very difficult to eradicate tuberculosis from developing countries like India³.

So how do we identify the ways to prevent antibiotic abuse? By understanding the basics of the problem. 

The main cause of antibiotic resistance is antibiotic use. When we use antibiotics, some bacteria die but resistant bacteria can survive and even multiply. The overuse of antibiotics makes resistant bacteria more common. The more we use antibiotics, the more chances bacteria have to become resistant to them.

Dr. M.G. Kartheeka, MBBS, MD

Why Does Antibiotic Resistance Occur?

Missing a dose of an antibiotic or taking it for inadequate duration are the most important cause of antibiotic resistance⁴. When you miss a dose or take fewer doses, the body is without enough medicine to combat the bacteria. This is the time when the microbes pull out defenses and start mutations or genetic changes that are favorable for it⁵. Moreover, India’s poor sanitation, inexpensive antibiotics, easy antibiotic availability and self-consumption of antibiotics as a quick fix act as contributing factors. 

It is understood that antibiotics will lose their ability to fight against bacteria over time, due to bacteria adapting to the evolving antibiotics and nature selects only the strongest to survive. The issue is alarming all over the world and thus it’s essential to know about the ways to prevent antibiotic resistance.  

Superbugs can often be resistant bacteria that can cause pneumonia, urinary tract infections and skin infections, careful selection of antibiotics is warranted.

Dr. Ashish Bajaj , M.B.B.S, M.D.

Ways to Prevent Antibiotic Resistance

1. Avoid using antibiotics for illnesses caused by viruses

• Antibiotics do not work for viral infections. This is because viruses use their host cells to perform their activity. Antiviral drugs are used for viral fevers or infections as they work by inhibiting the activity of viral enzymes. Most common viral infections are resolved by themselves with adequate rest and hydration and do not need antibiotics⁶. 

2. Do not share antibiotics

• The antibiotic becomes less effective more we use it. There is no use in sharing your antibiotic as the infection caused to the one with whom you share the antibiotic with will not be the same as yours. So, the antibiotic sharing will not ease their problem. Instead, it can make those bacteria resistant to this antibiotic. Therefore, dispose of any remaining antibiotics you have and do not share them with others⁷. 

3. Do not buy antibiotics over the counter

• Buying antibiotics without doctors’ prescription can lead to overuse or misuse of these medicines. This is the greatest risk factor for antimicrobial resistance. It is the easy accessibility of this medicine which causes overuse and thus resistance of bacteria towards the medicines. Apart from resistance, misuse or overuse of antibiotics can also cause other serious health conditions⁸. Government also needs to regulate over the counter availability of antibiotics in order to prevent misuse. 

4. Complete the course and do not miss doses in between

• Always complete the full course of an antibiotic even if you are feeling better. Stopping the antibiotics or missing doses will cause mutations to set in early and will promote the growth of antibiotic-resistant bacteria⁹. 

5. Do not pressurize your doctor

• Taking antibiotics unnecessarily is not good. It can cause several side-effects and might harm your body. Take antibiotics that are prescribed by a licensed doctor or a certified healthcare professional only. Ask if you really need them. Never pressurize your doctor to prescribe you an antibiotic unnecessarily¹⁰. 

More than anything it’s important to stay healthy and safe and prevent passing infections to others around you. Practice good hygiene methods, wash your hands properly, cover your face when you cough or sneeze and isolate yourself if you have an infection¹⁰. 

The Role of Healthcare Providers in Stopping Antibiotic Resistance

Healthcare providers play a huge role in preventing antibiotic resistance. They should prescribe the antibiotic only if it is necessary. They can explain to patients why hand hygiene is important. Let them know that timely vaccination is important for patients as well as for their family members. Providing proper education about the side effects and risks associated with antibiotics can help reduce misuse by patients¹¹. 

Conclusion

Antibiotic resistance is becoming a serious health problem in India. This is mainly due to the misuse and overuse of antibiotics. Sharing medicines, skipping doses, or buying antibiotics without a prescription leads to drug-resistant bacteria, making infections harder to treat. It’s therefore crucial to take antibiotics only if prescribed, take them in correct doses and for the prescribed course to prevent antibiotic resistance.  

References

1. Manesh A, Varghese GM. Rising antimicrobial resistance: an evolving epidemic in a pandemic. The Lancet Microbe. 2021 Jul;2(9). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8248924/ 
2. Dixit A, Kumar N, Kumar S, Trigun V. Antimicrobial Resistance: Progress in the Decade since Emergence of New Delhi Metallo-β-Lactamase in India. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine [Internet]. 2019 [cited 2019 Nov 11];44(1):4–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437806/ 
3. World. Antimicrobial Resistance [Internet]. Who.int. World Health Organization: WHO; 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance?utm 
4. Almomani BA, Hijazi BM, Awwad O, Khasawneh RA. Prevalence, and predictors of non-adherence to short-term antibiotics: A population-based survey. Brusa P, editor. PLOS ONE. 2022 May 19;17(5):e0268285. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9119442/ 
5. Kohanski MA, DePristo MA, Collins JJ. Sublethal Antibiotic Treatment Leads to Multidrug Resistance via Radical-Induced Mutagenesis. Molecular Cell [Internet]. 2010 Feb [cited 2019 May 14];37(3):311–20. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840266/ 
6. Better Health Channel. Infections – Bacterial and Viral [Internet]. Vic.gov.au. 2014. Available from: https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/infections-bacterial-and-viral 
7. Antimicrobial resistance. Use Antibiotics Only as Directed [Internet]. Antimicrobial resistance. 2017. Available from: https://www.amr.gov.au/what-you-can-do/general-public/prevent-and-control-infection 
8. Mittal AK, Bhardwaj R, Mishra P, Rajput SK. Antimicrobials Misuse/Overuse: Adverse Effect, Mechanism, Challenges and Strategies to Combat Resistance. The Open Biotechnology Journal. 2020 Sep 8;14(1). Available from: https://openbiotechnologyjournal.com/VOLUME/14/PAGE/107/FULLTEXT/ 
9. NHS inform. Antibiotics [Internet]. www.nhsinform.scot. 2024. Available from: https://www.nhsinform.scot/tests-and-treatments/medicines-and-medical-aids/types-of-medicine/antibiotics/ 
10. CDC. Healthy Habits: Antibiotic Do’s and Don’ts [Internet]. Antibiotic Prescribing and Use. 2024. Available from: https://www.cdc.gov/antibiotic-use/about/index.html 
11. National Foundation for Infectious Diseases. Antibiotic Resistance [Internet]. National Foundation for Infectious Diseases. NFID; 2019. Available from: https://www.nfid.org/antibiotic-resistance/  

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