Unchecked antibiotic use: Doctors in Kashmir sound alarm on superbugs

Srinagar, Jan 21: Calling antimicrobial resistance (AMR) a hidden pandemic of our time, doctors in Kashmir have urged people to abandon self-medication with antibiotics and adhere strictly to prescriptions in a bid to combat this growing threat.

The lack of a concrete antibiotic policy in Kashmir fuels the flames of AMR.

As per the doctors, the rampant misuse paves the way for the emergence of "superbugs", bacteria resistant to existing antibiotics, creating a nightmare scenario where even minor infections become untreatable.

They said that the unregulated and unwarranted dispensing of medicines by chemists without prescriptions needs to be addressed by regulatory authorities.

“Awareness among the masses regarding the judicious use of antibiotics shall be the priority of health systems enabling scientific use of antibiotics,” they said.

Directorate of Health Services Kashmir spokesman, Dr Mir Mushtaq told Greater Kashmir that the advisory should be strictly followed by all health institutions, including chemists, across Kashmir.

He said that hospitals in Kashmir should have a proper antibiotic policy and that there should be collaborative efforts from the health and drug departments, including chemists.

“We should not allow people to buy antibiotics without prescriptions,” Dr Mushtaq said. “Self-medication is very common in Kashmir. Besides, doctors should mention a reason for prescribing antibiotics to their patients. There should be a ban on over-the-counter drugs without proper prescriptions.”

Head of Community Medicine at Government Medical College (GMC), Dr Saleem Khan told Greater Kashmir that AMR is the biggest hidden pandemic in the world, primarily due to the erratic prescription of antibiotics.

“The free availability of antibiotics as over-the-counter medicine whenever a patient approaches a pharmacy or when patients approach a chemist for treatment of minor illnesses is also one of the major causes in the emergence of drug-resistant superbugs,” Dr Khan said.

He said that these superbugs are resistant to available antibiotics and pose a major challenge in treating not only life-threatening diseases but even minor illnesses, which could turn into untreatable ones as microbes are resistant to available antibiotics.

Dr Khan stressed the importance of rational use of antibiotics, which includes prescribing them only after culturing body fluids and determining the drug sensitivity of the particular microbe cultured.

“Over 80 to 90 percent of antibiotics are unnecessarily prescribed,” Dr Khan said. “In the first instance, there may be no need for antibiotics at all. Or, first-line antibiotics may be prescribed empirically. However, it is best to find out the causative microorganism causing the disease and treat specifically against the microbe susceptible to particular antibiotics. This applies to all doctors prescribing antibiotics, be it in the government sector, including doctors in PHCs, CHCs, district hospitals, or tertiary care hospitals like medical colleges.”

He also called for each hospital to have its own antimicrobial (antibiotic) policy drafted by experts from various specialities and for antibiotic stewardship to be established in medical colleges to measure and improve how antibiotics are prescribed by doctors and used by patients.

Recently, the Union Health Ministry issued an advisory regarding the indiscriminate use of antibiotics, with doctors specifically mentioning the reason for prescribing antibiotics to each patient.

Pharmacists have also been asked to stop selling these drugs over the counter without a doctor's prescription.

According to the letter, antimicrobial resistance is estimated to have been directly responsible for 1.27 million global deaths in 2019, while 4.45 million deaths were associated with drug-resistant infections.