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Usage of Antibiotics



Questioning if they have outgrown their effectiveness given its overuse.

The case of the six-year-old girl who developed antibiotic resistance is not an isolated one in the world of antibiotics.

As these super drugs are routinely prescribed, controversies on their abuse and overuse are beginning to throw a big question-mark on whether antibiotics have outgrown their effectiveness.

The question doing the rounds in many medical corridors is: Is the golden age of antibiotics over?

“No, this is not true,” said Dr Sandeep Pargi, Specialist in Respiratory Medicine at Aster Mankhool Hospital, Dubai.

“Antibiotics still have a great scope as new ones are being discovered. There are some old-generation antibiotics that are being phased out due to resistance [issues] but many are being discovered as we speak.”

Dr Pargi believes doctors need to rely a lot on old-fashioned diagnosis before rushing in to prescribe antibiotics. “Antibiotics work against bacterial infections. Very often, doctors prescribe antibiotics for viral fever and infections which would anyway subside within a week.”

Dr Pargi said, “An antibiotic course is either three, five, seven or nine days. None of the antibiotics go beyond 14-day prescriptions except those administered in case of tuberculosis.

“If the course is three days, then that is what one needs to follow. If the course is 14 days, follow that. The danger arises when people self-medicate, get over-the-counter antibiotics and switch from one to another on their own. They might take two or three antibiotics for a longer period and develop resistance.”

Overuse can occur only when there is trial and error with different types of antibiotics which usually occurs when people self-medicate, said doctors.

Patients can be prescribed antibiotics as many times as they need through the year, provided the protocol and guidelines are followed. Every hospital around the world follows a set antibiotic policy. In Scandinavian countries especially, doctors are judicious in prescribing antibiotics. When this strategy is followed, which should be the case in the rest of the world, there is little danger of resistance, said Dr Pargi.

“In tuberculosis, when a person has the disease for the first time, we begin with the first line of multi-drug therapy. Usually, the disease is cured with a course of six months to a year. When a person has TB for the second time, it means the first line of drugs is not likely to be effective so we put him on multi-drug therapy (with a combination of four-seven drugs). When the disease recurs, it means the strain has developed multi-drug resistance (MDR). When this fails, we prescribe XDR or extreme drug resistance therapy,” Dr Pargi said.

Regarding the superbug scare, Dr Pargi refutes the hype. “There is no such thing as a superbug syndrome. In some areas of the world, a lack of hygiene in hospitals gives rise to resistance within the hospital. There is no uniform superbug syndrome. For instance, hospitals in Dubai have no superbugs.” If hospitals do three things, we need not fear superbugs:

1. Follow a definite antibiotic guideline and policy and avoid indiscriminate use;

2. Use them judiciously with ensuring correct protocal of duration, potency and dose is followed; and

3. Maintain hygiene standards in their environment.

Testimonial

Latifa Dumalag, 48, Filipina Came out from a life-threatening pneumonia with judicious and effective use of antibiotics.
“I have been suffering from bronchitis and asthma since childhood and have a weak respiratory system. So I did not realise that what seemed to be like a normal cough and cold would rapidly develop into bronchitis and pneumonia. I consulted one clinic first and they gave me medication which was ineffective, and I continued to cough and wheeze. 
“When I contracted fever and could hardly breathe, I was referred to Aster Hospital under Dr Sandeep Pargi who literally brought me back from death. I was put on IV antibiotics and once I recovered after nearly 10 days in hospital, I was given multivitamins and discharged in the first week of October. 
“I am 95 per cent cured and still have to get constitutionally stronger. But the right dose of antibiotics saved my life.”