Indiscriminate use of antibiotics leading to resistance: ICMR

New Delhi : The Indian Council of Medical Research (ICMR) has issued guidelines that warn against the use of antibiotics for conditions such as low-grade fever and viral bronchitis, while advising doctors to follow a timeline when prescribing them. Health experts in the city claimed that several other antibiotics are being misused for certain conditions and are developing resistance among patients.

Dr Ashwini Kumar Setya, senior consultant, Medanta Institute of Digestive & Hepatobiliary Sciences, said every antibiotic is available over the counter without prescription. Though regulations exist on paper, chemists don’t follow them and are in fact practising quackery. “In most hospitals, fourth generation antibiotics are used because doctors tend to do more due to patients’ expectation to get quick results,” he said.

For instance, 70% of diarrhoea cases are viral diarrhoea, for which antibiotics are not needed but are being prescribed by doctors, he added.

He further said the most misused antibiotics are norfloxacin, ciprofloxacin, ofloxacin and levofloxacin. “These are being used for diarrhoea and for UTI in women,” he said, adding that amoxicillin are also being widely used.

He stressed that it is necessary to diagnose whether the infection is bacterial or not before prescribing antibiotics. “Antibiotics are being widely used for viral diseases,” he said, adding that self control and regulation need to be practised by all stakeholders.

Prof Kabir Sardana, from the dermatology department at RML hospital, said that since acne is not an infection, there is little scientific rationale of using antibiotics, which merely work on inflammation.

“Azithromycin, which is useful for many medically important disorders, is being prescribed for acne, where a high level of resistance is seen to macrolides (a class of drugs used to manage and treat various bacterial infections). It is unfortunate. This is when there is very high quality data from Japan and India that doxy or minocycline is much better, if needed, for acne,” he said.

Dr Tarun Sahni, senior consultant in internal medicine, Apollo hospital, said, “There was widespread use of azithromycin and ivermectin during Covid and this too has led to resistance.”

Sometimes antibiotics get promoted in the community or areas where doctors are either not experienced enough or they don’t have infrastructure to test which antibiotic is appropriate. “Promotion of antibiotics by pharma companies should be looked into,” he said.