Do you hate going to the doctor and do you take self-medication? If yes then here we come to know why self-medication is dangerous to health. Your refusal to undergo a checkup and your denial perhaps to get a prescription could be fueling a dangerous trend. According to a Lancet study, Indian are consuming illegal antibiotic medicines that are not approved by the health authorities i.e. CDSCO and SDRAs, because most Indians take antibiotics at will i.e. self-medication, they would much rather seek medical advice from their family or get a prescription from their friendly chemist over the counter who is not certified. Unapproved antibiotics are circulating in the market.
According to the Lancet’s study on the consumption of antibiotics in India, India is the largest antibiotics consumer in terms of absolute volume, but India does not have a surveillance system those found in US and Europe to guide antibiotics use and the result of that is worrying. (1)
What are antibiotics? Antibiotics are medicines that fight infections caused by bacteria either by killing the bacteria or stopping them from multiplying. Antibiotics must be consumed only on a doctor’s advice.
In India, citizens don’t mind taking high-intensity drugs without even consulting an expert doctor, citizen either go by the advice of friends and family or the recommendations of a chemist who is not certified. This is exactly what the lancet study conducted by researchers from Boston University in the US and the public health foundation of India, New Delhi, states that Indians are consuming medicines without the prescriptions of a doctor, based on data from PharmaTrac, a private sector drug sales data set, gathered from a panel of nine thousand (Stockists) representatives of antibiotic sales across India. This data says that, in 2019, Indians consumed over 500 crore antibiotics, that’s around 5 billion antibiotics. Indians consumed this figure in just one year, which were the most used antibiotics-
Number one is an antibiotic used for infections and colds i.e., Azithromycin 500mg. It was the most consumed antibiotic formulation at 7.6 per cent, which is equal to some 384 million doses consumed annually.
On the second spot was cefixime 200mg tablet. An antibiotic used to treat strep throat. It was the second most consumed medication at 6.5 per cent, which is equal to some 331 million doses consumed annually.
The study says close to 50 per cent of antibiotic formulations that are sold in India’s private sector are unapproved and this also includes fixed-dose combinations or FDCs. What are they? They are medicines that contain two or more active ingredients, for instance, Amoxicillin-clavulanic acid 500/125mg tablet. The study says that Amoxicillin-clavulanic acid 500/125mg tablet is the most consumed FDC at 6.4 per cent which is equal to some 325 million doses consumed annually.
In India, two bodies look after the distribution of such drugs:
- The CDSCO – Central Drug Standard Control Organization
- The SDRA – State Drug Regulatory Authorities
These two bodies share responsibility for pharmaceutical sales.
Around 48.7 per cent meaning 48.7 FDCs sold in the Indian market are unapproved or are discouraged by the World Health Organization. In fact, India sells the highest number of unapproved FDCs followed by China, West Africa, and Vietnam.
Macrolides and Cephalosporins are both a certain class of drugs, used for a wide range of infections. In India, 90 per cent of Macrolides and 61 per cent of Cephalosporins are sold in the market without the approval of the central agency and this inevitably helps them get approval from the state govt which has the limited technical capacity to decide on the merit of approval. Unapproved antibiotics are being sold in India for just everything- sore throat, respiratory problems, a stomach bug.
According to Lancet’s study: Antibiotic resistance is a public health challenge that affects the entire world. Antibiotic resistance in India has been linked to inappropriate human use of antibiotics.
The study says this sort of ignorance and inappropriate use of medicines is a significant driver of antibiotic resistance in India. In other words, it is rendering medical drugs ineffective, making it harder for medicines to kill bacteria, not just for cold and fever but also for infections like pneumonia, tuberculosis, and blood poisoning. They are all becoming harder and sometimes difficult to treat. The reason is an increase in the consumption of unapproved antibiotics.
A chemist would only suggest a medicine but doctors, on the other hand, prescribe an entire course of antibiotics, complete with high and low doses that are required to kill the bacteria. If we are to kill the bacteria completely, we must complete the full course does not pop any medicine randomly. Because bacteria are like any microbial organism which multiply in favorable conditions and pass the DNA to their offspring, if we don’t use effective medicines, if we don’t prescribe a proper course, the bacteria develop a certain resistance to antibiotics and can pass this resistance onto their daughter cells. If we misuse, overuse or underuse antibiotics, our chances to kill bacteria go up for a toss and this only weakens our immune system, it makes us ill-equipped to deal with future illnesses. This is what the study means by antibiotic resistance. One of the countries with the highest rates of antimicrobial agent resistance in India.
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