Misuse of Antibiotics in India During COVID-19 Increases Risk for Drug-Resistant Infections

Antibiotics are designed to fight bacterial infections, they won't work on viral infections such as COVID-19. But the rise in antibiotic sales in India indicates inappropriate use of the drugs to treat mild and moderate COVID-19 infections, says a new study.

The novel coronavirus, which is responsible for the ongoing COVID-19 pandemic, has infected more than 3 crore people and claimed nearly 4 lakh lives in India. While the country is seeing a decline in Covid-19 cases, researchers have warned of the emergence of another public health crisis - the widespread misuse of antibiotics.

According to a new research, sales of antibiotics soared during India's first surge of COVID-19, suggesting misuse of the drugs to treat mild and moderate COVID-19 infections. The authors noted that antibiotics are only effective against bacterial infections, not viral infections such as COVID-19. The finding is especially concerning because antibiotic overuse increases the risk for drug-resistant infections, they stated.

Antibiotic resistance is one of the greatest threats to global public health. Overuse of antibiotics lessens the drugs' ability to effectively treat minor injuries and common infections such as pneumonia. Bacteria that have become resistant to antibiotics can spread to any person in any country said the study's senior author, infectious diseases specialist Sumanth Gandra, MD, an associate professor of medicine and an associate hospital epidemiologist at Barnes-Jewish Hospital.

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The study conducted by Washington University School of Medicine in St. Louis in collaboration with McGill University in Canada, is published July 1 in PLOS Medicine.

India is the largest consumer of antibiotics in the world

On the contrary, overall antibiotic use plunged in high-income countries such as the United States, United Kingdom and Canada last year, even during COVID-19 peaks. The reason is that physicians in these countries generally did not prescribe antibiotics for mild and moderate COVID-19 cases, Gandra explained.

The Indian Health Ministry and WHO have warned against use of antibiotics for mild and moderate forms of COVID-19 infections, which account for more than 90% of the COVID-19 cases. "Antibiotics should only be given to patients who develop secondary bacterial illnesses," Gandra said, as quoted by Science Daily.

The rise in antibiotic sales in India indicates that COVID-19 guidelines were not followed, noted Gandra, suggesting the need for policy changes in India.

India is the largest consumer of antibiotics in the world, and a poster child for antibiotic misuse in low- and middle-income countries with similar health-care practices, said Gandra, who is also a member of a World Health Organization (WHO) team working on reducing antibiotic prescriptions in low- and middle-income countries.

Gandra blamed the unregulated private sector, which accounts for 75% of health care and 90% of antibiotic sales In India, for antibiotic overprescription in the country. Also, in low- and middle-income countries, most people cannot afford diagnostic testing for respiratory illnesses, which make them take antibiotics under the assumption that their illness is bacterial.

Consequences of inappropriate use of antibiotics

Antibiotics are medications that are designed to fight bacterial infections, by killing the bacteria or preventing them to grow and multiply. But taking antibiotics when they are not needed can cause side effects and contribute to antibiotic resistance. When the bacteria become able to resist the effects of an antibiotic, meaning they are not killed and continue to grow, the infections or illnesses can become serious and deadly. In addition, antibiotic resistance will increase hospital stays and medical costs.

Take note, antibiotics should not be taken for colds and runny nose, most sore throats (except strep throat) and flu as these are viral infections.

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