Misuse of antibiotics in man can lead to serious problems as the microbes develop resistance, i.e., they become non-responsive to their subsequent use. The World Health Organization (WHO) theme to counter microbial resistance to antibiotics (April 2011) warrants serious attention of the regulatory authorities, namely the Drug Control Authority, and the Medical Council of India (MCI) which is responsible for educating the young doctor.
Simply speaking, bacteria are naturally susceptible to some antibiotics, and resistant to others as is evident on culture and sensitivity (C & S) studies. But ceratin strains develop resistance to antibiotics to which they are supposed to be normally responsive, notably the staphylococci, gram-negative bacilli, and the tubercle bacilli. However, such resistance can be developed by any organism as a result of indiscriminate use of antibiotics. The main types of resistance are: natural and acquired. The natural resistance is genetically determined, while acquired resistance is developed by a previously responsive microbial species. In fact, such resistance poses serious clinical problems as it weakens the physician's antimicrobial arsenal.
Various mechanism(s) like mutation, adaptation, and dependence are responsible for the development of acquired resistance. The major factor is unnecessary exposure of microbes to antimicrobial drugs, and use of antibiotics for treating trivial infections must be avoided. Ideally antimicrobial therapy must be based on - proper identification of the microbe, sensitivity tests (if available), and proper selection of the drug or drug combination. Development of multidrug resistant (MDR) tuberculosis, typhoid, and staphylococcal infection(s) have already become a problem.
Steps to avoid and tackle thus situation are:
- strict drug control;
- 'prescription audit' to rationalise prescribing habits to check irrational polypharmacy;
- have trained pharmacists in hospitals, clinics, and the market;
- steps be taken against quackery; and
- making the layman conscious of the dangers of self-medication and non-compliance of physician's instructions.
An honest effort in these direction(s) only can counter this fast growing menace.