Antibiotics are a group of drugs used for treating a wide variety of infections. As the name suggests, anti means against and bios signifies life.  These are drugs which act against the life of microbes. Thus, they are very useful and indispensable in treating different infectious conditions. They have helped in reducing the load of infectious diseases.

Due to use of antibiotics for several decades, many serious issues are now coming up, including antibiotic resistance.  Microbes are getting resistant to the existing antibiotics.  This has happened due to antibiotics being used indiscriminately or in insufficient doses.   People use antibiotics by self-medication, that too where not needed as in mild coughs or cold. A person may use antibiotics remaining from a previous prescription without having a clear need for it. The doctor may be pressurised to write an antibiotic without waiting for test results. Even a doctor may prescribe antibiotic empirically due to rush of patients or lack of adequate tests to detect the underlying germs responsible for the infection. Specific antibiotics are useful for specific infections, like amoxicillin is active against microbes causing infections of the respiratory system.  Using an   antibiotic indiscriminately for an infection does not help in cure and also tends to make the microbes resistant.  Due to one or more of all these reasons, the infection causing microbes adapt and change their body such that they are no longer killed by the medicine given.  Antibiotic resistance is not only an individual concern but a public health one. Any infection will occur in a more severe and sometimes deadly form, spread more rapidly and be difficult to halt if antibiotics do not act on the causative germs.

Some bacteria normally reside in various parts of the body in a friendly way, as in mouth, gut, vagina, and urinary tract. These bacteria also help in body functions, for example, bacteria present in gut aid in digestion and also produce B complex which is helpful to the body.  Antibiotics kill these germs as well, along with disease producing microbes, thus disturbing body functions. One can develop ulcers over the mouth or tongue due to depletion of gut flora or anaemia due to depletion of folates of body.

There are several conditions where antibiotics are not needed. Common cold, cough, acute diarrhoea, many such conditions are caused by viruses and do not need antibiotics. Moreover, these conditions are self-subsiding and improve with just palliative care. Similarly, they are not useful for allergic cold or cough. Using antibiotics for them, does not help much and contributes to growing antibiotic resistance.

Some antibiotics like fluoroquinolones tend to interfere with skeletal growth of a child. Tetracycline causes permanent discolouration of teeth and uncomfortable photophobia, i.e. pain on looking at light.  Sulphur group of drugs like Bactrim, chloramphenicol are known to cause anaemia.  As for any other substance, allergy can be to antibiotics as well. Penicillin and sulphur drugs are known to cause life threatening allergic reactions. There is a long list, no antibiotic is hazard free.

Collective efforts by all concerned can help to solve the rising problem of growing antibiotic resistance and help to ensure that they are used effectively and safely. People need to be more aware of preventive measures regarding infectious diseases. Improving personal and food hygiene goes a long way in prevention of these problems. People also have to be more aware of the antibiotics one has been prescribed, why it is important to take it in prescribed dose and why antibiotics should not be taken unless prescribed by a doctor. They should also know the possible side effects and report if any adverse effect occurs.

Antibiotics are a very important tool for good personal, as well as public health, and should be used judiciously.

                          Dr Rachna Pande,                                                      

Specialist, internal medicine

rachna212002@yahoo.co.uk