In a hospital the death of a patient is usually accounted to the severity of a disease. Even for a clinician who has been practicing for years, the concept of a “superbug”
causing life- threatening problems is sometimes hard to comprehend.
However, the emergence of superbugs- antibiotic resistance organisms- that are holding their ground against the usual antibiotics is now a reality in South Asia. The antibiotics have remained the same and the bugs have found ways to evade even the strongest of them. In fact many of our intensive care units are using what are termed ‘last resort’ antibiotics such as carbepenems and polymixin to treat patients.
Many of us including doctors believe that pharmaceutical companies will continue to research and produce antibiotics that will effectively take care of even the most dangerous infections. But the reality is that most pharmaceutical companies are spending their money in researching drugs for chronic illnesses like diabetes, heart disease and cancer and the investments in antibiotics are at an all time low.
Recent news stories and editorials in the western media have made it increasingly clear that South Asia is a prime area for superbugs to thrive in. Easily obtained over-the-counter antibiotics, overcrowding, lack of toilets and untreated sewage lead to infection and usage of antibiotics. Recent studies have also shed light on how mothers may be acting as carriers in transmitting these superbugs to their children. In this sense newborn babies with weak immune systems are especially vulnerable.
A study conducted in New Delhi showed that widespread use of antibiotics in chicken feed resulted in antibiotic residue in chicken products. These residual antibiotics found in animal products when consumed, may lead to antibiotic resistance in humans. A similar study is now being conducted in Nepal by motivated veterinarians and there is every chance that chickens in our country have just as much antibiotic residue as in India.
Many developed countries now have laws to curb the practice of adding antibiotics to animal feed to avoid antibiotic resistance in people. Indiscriminate, sub therapeutic use of antibiotics for animal growth promotion must be stopped by governments. If India takes the lead in this venture, it will probably be easier for smaller countries in the sub-continent like Nepal to follow suit, because its pharmaceutical commerce is closely linked with India.
Antibiotics are often termed as ‘miracle drugs’ and are perhaps the most important discovery that changed human lives. In many parts of the world (including ours) many patients continue to die due to lack of proper access to these life-saving drugs. But it is the ubiquitous infections due to poor sanitation and often unnecessary and overuse of antibiotics that are enabling these superbugs to be a killer amongst us.
Superbugs, Buddha Basnyat
Antibiotic resistance: a reality, Buddha Basnyat
Dodging the silver bullet, Buddha Basnyat
Multiple resistance, Juanita Malagon
Pushing drugs, Kiran Nepal
Stoves and toilets, Buddha Basnyat