Written by Dr. Rachna Kucheria (MBBS MAMC New Delhi, MD AIIMS New Delhi, MD (Family Medicine) USC California)), one of the best general physicians in Delhi.
A few days ago, I read about a woman dying of an infection resistant to 26 different antibiotics in the US. I fell into despair. And it only worsened as I went on to read that she had returned to the US after a long stay & treatment in India. She was suffering from New Delhi Metallo-beta-lactamase or NDM (a multi-drug-resistant bacteria).
This incident is part of a rampant and increasing problem called antibiotic resistance. Most of us, at some point, are guilty of not completing a prescribed antibiotic course because we feel better just a couple of days into the 5 or 7 day course. We also tend to self-medicate and prescribe ourselves antibiotics when they are not really needed.
How does this all add up to the kind of awful antibiotic resistance in the news?
First, a few basics-we all have bacteria in our bodies – throat, nose, gut etc. When we pop-in antibiotics only for a few days, we kill the ‘sensitive to antibiotic bacteria,’ and leave behind the ‘resistance prone bacteria’. We inadvertently target only the weakest bacteria and leave the stronger ones untouched. These bacteria now have a full playing field to grow and prosper. A full course of treatment kills the resistance prone ones. Each time we take antibiotics unnecessarily, we give our inherent bacteria an inoculum against the bacteria and opportunities to develop resistance to it.
This real and growing risk of antibiotic resistance means a person could get very sick, or die of a very common infection like Urinary Tract Infection (UTI). This is because antibiotic abuse has made our own bacteria resistant. Or we are catching the illness from a resistant-bacteria infection. Pharmaceutical companies are not developing any new antibiotics. We cannot afford any resistance.
Things you can do
However, patients are not powerless to fight this. If you fall ill, don’t begin to demand antibiotics of your doctor. More importantly, don’t start taking antibiotics on your own. You should ask questions about the prescription your doctor gives.
Remember one thing: antibiotics fight bacteria, not viruses. Viruses cause illnesses like colds and diarrhoea or colds which don’t need antibiotics. In these cases what you need are simpler measures. Often you need to simply wait for the body to get rid of the virus naturally.
In our practice, (Dr. Rachna Kucheria, leading GP in New Delhi) we regularly make an agreement with the patient about a watch and wait for plan. We counsel them on when to start antibiotics and how long they can safely do without them.
The WHO & government bodies have also put together plans, one of which is the Chennai Declaration. It is a roadmap developed at a joint meeting of medical societies in India held in Chennai in August 2012 to curb this serious problem.
But we as citizens can also contribute by auditing our own consumption and prescription of antibiotics. We should be aware of the contribution that each one of us can make so that antibiotics continue to protect us, in the way that we have known them to.
About the Author
Dr. Rachna Kucheria is one of the best general physicians in India. She is a US-trained Physician (Family Practice) on the lines of the old-fashioned ‘Family Doctor’ we grew up with and hope to find again. Her emphasis on early, accurate diagnosis; appropriate (few) medicines; and clear patient communication, sets her apart as one of the most trusted physicians in Delhi. She is licensed to practice medicine both in India & California. Her 27 years of experience includes practicing in the hospital, clinic, and (patient) home setting, and for the last 4 years, telemedicine.
DocGenie is an online telemedicine platform that provides you with quality healthcare from the best doctors in the comfort of your own space. On DocGenie, you will find a select few, highly-qualified doctors, unlike other online platforms with thousands of doctors. So you can be assured of receiving excellent, honest, personalized care from the best professionals.