This thing called Antibiotics
Another OPD session. A young woman walks in along with her concerned husband. She has high grade fever. I do the routine general physical examination and I conclude that she has a regular viral fever. I tell the patient to take lots of fluids and take rest. I prescribe to her some paracetamol tablets and ask her to see me in a couple of days if she is not feeling better.
Her husband looks at the prescription and gives me a weird look. He asked me: "Doctor, this I could have given her. Could you please give her some antibiotics? My aunt told me nowadays for Bangalore fever only Augmentin works...." (well informed aunt I say!)
One of the biggest discoveries of modern medicine is the discovery of antibiotic "Pencillin" by Alexander Fleming in 1929. 1930s to 1960s was considered to be the Golden Era of antibiotic discovery. During that period, success seemed to be a routine affair so it was called golden and its called an era because it ended. Alexander Fleming himself sounded the first warning about "antibiotic resistance" even as he was accepting the Nobel Prize for the discovery of Pencillin in 1945.
"Antibiotic resistance" is one of the biggest challenge we are facing today. A post antibiotic era in which common infections and minor injuries can kill is a very real possibility for the 21st century. It is really scary, by the time I see the patient in OPD they have already been on antibiotics either self medicated or prescribed by some other doctor.
A week back one of the GP referred a case of seizures. He told me patient had 2 episodes of seizures that day, following sore throat and fever the previous day. Seizures followed by fever, there are so many differential diagnosis (meningitis, encephalitis just to begin). Clinical examination was completely normal of course it is not surprising. History wise all he had was mild fever, cold and bit sore throat, I realised something was not fitting. I questioned him about alcohol intake and any over the counter medications. Then he said he took levofloxacin commonly used antibiotic 500mg that morning . There it was! Seizure is one of the known side-effects of Levofloxacin. He said the medical shop guy gave him.Lucky for him he was not driving or doing any high risk activity at that time.
That is the degree of misuse of antibiotics in our country. Viral infections like common cold, sore throat and even Dengue fever don't need any antibiotics. All the patient needs is good rest and hydration.
"Antibiotic resistance" in itself is a very a big topic, I will blog about it perhaps at a later date. Here are few pointers for general awareness on antibiotics and antibiotic resistance.
What is antibiotic resistance?
When an antibiotic is no longer effective in killing or limiting the growth of bacteria. Bacteria are the champions of evolution. They evolve each day into much dangerous forms posing a very serious challenge to us.
Why should I be worried?
Antibiotics were considered to be the magic bullet that could treat almost any bacterial infection. With antibiotic misuse almost all the bacteria are resistant to common medicines. Someone with an infection that is resistant to a certain medicine can pass that resistant infection to other people, including family members, and co-workers. This way we can have a hard to treat serious infection in the community itself .This can be extremely dangerous for young children, elderly population, someone with weakened immune systems as they are all vulnerable.
What can we do?
Everyone has a role to play. Here are few tips
Next time somebody says Bangalore fever gets better only with Augmentin, you gift them a Kinley water bottle!
Her husband looks at the prescription and gives me a weird look. He asked me: "Doctor, this I could have given her. Could you please give her some antibiotics? My aunt told me nowadays for Bangalore fever only Augmentin works...." (well informed aunt I say!)
One of the biggest discoveries of modern medicine is the discovery of antibiotic "Pencillin" by Alexander Fleming in 1929. 1930s to 1960s was considered to be the Golden Era of antibiotic discovery. During that period, success seemed to be a routine affair so it was called golden and its called an era because it ended. Alexander Fleming himself sounded the first warning about "antibiotic resistance" even as he was accepting the Nobel Prize for the discovery of Pencillin in 1945.
"Antibiotic resistance" is one of the biggest challenge we are facing today. A post antibiotic era in which common infections and minor injuries can kill is a very real possibility for the 21st century. It is really scary, by the time I see the patient in OPD they have already been on antibiotics either self medicated or prescribed by some other doctor.
A week back one of the GP referred a case of seizures. He told me patient had 2 episodes of seizures that day, following sore throat and fever the previous day. Seizures followed by fever, there are so many differential diagnosis (meningitis, encephalitis just to begin). Clinical examination was completely normal of course it is not surprising. History wise all he had was mild fever, cold and bit sore throat, I realised something was not fitting. I questioned him about alcohol intake and any over the counter medications. Then he said he took levofloxacin commonly used antibiotic 500mg that morning . There it was! Seizure is one of the known side-effects of Levofloxacin. He said the medical shop guy gave him.Lucky for him he was not driving or doing any high risk activity at that time.
That is the degree of misuse of antibiotics in our country. Viral infections like common cold, sore throat and even Dengue fever don't need any antibiotics. All the patient needs is good rest and hydration.
"Antibiotic resistance" in itself is a very a big topic, I will blog about it perhaps at a later date. Here are few pointers for general awareness on antibiotics and antibiotic resistance.
What is antibiotic resistance?
When an antibiotic is no longer effective in killing or limiting the growth of bacteria. Bacteria are the champions of evolution. They evolve each day into much dangerous forms posing a very serious challenge to us.
Why should I be worried?
Antibiotics were considered to be the magic bullet that could treat almost any bacterial infection. With antibiotic misuse almost all the bacteria are resistant to common medicines. Someone with an infection that is resistant to a certain medicine can pass that resistant infection to other people, including family members, and co-workers. This way we can have a hard to treat serious infection in the community itself .This can be extremely dangerous for young children, elderly population, someone with weakened immune systems as they are all vulnerable.
What can we do?
Everyone has a role to play. Here are few tips
- Use antibiotics wisely: Don’t expect to get antibiotics every time you have a respiratory infection. Know when it’s effective to use antibiotics and don’t use them for viral infections such as colds, flu, coughs, and most sore throats. Even with some bacterial infections, you will usually recover just as quickly without antibiotics.
- Take antibiotics exactly as prescribed: If you are prescribed antibiotics, follow the dose and schedule instructions exactly. Finish all the antibiotics you are given, even if you start to feel better. Do not share them with someone else or save them for another time.
- Never take antibiotics without prescription: The pharmacist does not know about all the side effects.
- Stay at home if your sick: Drink plenty of fluids, take adequate rest, practise good hand hygiene.
Next time somebody says Bangalore fever gets better only with Augmentin, you gift them a Kinley water bottle!