Creative Producer: Puneet Bhatia
The drugs don't work - no, not rock song by the Verve. This is our reality, a crisis that, experts warn, could lead to another, even graver pandemic.
What happens when the pathogens that could once be easily treated with certain drugs develop resistance to those drugs, and illnesses that were considered mild become life-threatening?
This is called Antimicrobial Resistance, and it threatens to undo all the progress we have made in modern medicine.
At the epicentre of this crisis is overuse of antibiotics. But there's more to it than just building tolerance to some drugs.
What is AR? What role do you have to play in it? How does it impact you?
FIT breaks it down.
The Rise and Fall of Antibiotics
First, here's a quick history refresher.
In 1928, a man named Alexander Flemming discovered penicillin – the first antibiotic. This pretty much changed the course of healthcare.
Antibiotics are basically medicines that destroy or slow the growth of harmful bacteria.
But, pathogens like bacteria grow stronger by developing resistance to the drugs that are used to treat them, and, infections that could be easily treated like UTI, E. Coli, and Staph infections become untreatable.
This is called Antimicrobial Resistance.
Now, AR is not a new phenomenon. In fact, cases of penicillin resistance started being noted just 20 years after its discovery.
What's concerning, though, is that since then the problem has grown exponentially.
A report by the University of Oxford, the first of its kind found that 1.2 million deaths in 2019 were directly linked to AMR. That's more than HIV and Malaria.
To get to the bottom of what's driving this crisis of drug resistance, and where it's likely to lead us, we spoke to Dr Sumit Ray, head of Critical Care at Delhi's Holy Family Hospital.
"I'm an intensivist, so I take care of critically ill patients in the ICU, and in these patients we do see antimicrobial resistance, and it's a big worry," he says.
"It is unfortunately extremely common. Even one of our studies showed, done previously, 60 percent of the patients coming with E Coli, Sepsis infections from the community these are two major bacterial infection have antimicrobial resistance to third generation antibiotics."Dr Sumit Ray, critical care specialist, Holy Family Hospital, Delhi
Dr Ray goes on to say that as a result of this, they are forced to use stronger antibiotics, which were considered very toxic earlier.
"The more antibiotics of a certain kind we use, the potential for bacteria to develop resistance increases," he adds.
What is Fuelling This Hidden Pandemic?
"So the reason for why we have so much antimicrobial resistance is actually multifactorial, at multiple levels," says Dr Ray.
Some reasons for this are:
Easy access to over-the-counter antibiotics in this country.
"Even restricted antibiotics – which in hospitals if a doctor prescribes, he needs to explain why we are using the antibiotic – can be bought over the counter in this country."Dr Sumit Ray, critical care specialist, Holy Family Hospital, Delhi
Prescription practices of doctors.
He says sometimes doctors prescribe very high percentage of antibiotic prescriptions even for the mildest of infections like cold, Diarrhoea etc which are usually viral infections.
"There, antibiotics don't work. They are only to be used in bacterial infections," he adds.
"The tendency is to prescribe multiple drugs so that at least something will work which is in a sense, very unscientific, improper and that leads to very high antibiotic prescription."Dr Sumit Ray, critical care specialist, Holy Family Hospital, Delhi
Many of the smaller hospitals don't have microbiology departments.
"So, they don't have data of what is the bacteria that is causing the infection. What is its resistance pattern? What antibiotic should be appropriate for this? So we're shooting in the dark."Dr Sumit Ray, critical care specialist, Holy Family Hospital, Delhi
What Can We Do?
The situation is worrisome, but, Dr Ray believes there is still hope.
"We have to have hope but also in the process develop ways of countering it, that is multifactorial, at multiple levels," he says.
As consumers, you can do your bit. Some things to keep in mind are,
Taking antibiotics only when you need them
Take antibiotics exactly as prescribed
Ask your doctor to explain your prescriptions, and what each drug is meant for
You can help keep antibiotics working, by using them right.
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