Antibiotic Resistance an Alarming Situation!!!

 By: Naresh Banskota

Got a seasonal cough, we go to a pharmacy and ask for Azithromycin! Got a minor fever, cold or even headache, antibiotics have become the first choice medicine in Nepal. We take one or two pills and as soon as the symptom decreases we stop taking pills. No one cares about the dose, or for what purpose antibiotics are used, neither the pharmacist nor the patient.

“Taking Antibiotics has become like eating a chocolate in Nepal. Just go to a pharmacy,pay Rs.10/15, shopkeeper gives you a pill and then you take it.” I am using a word shopkeeper instead of pharmacist because they really don’t care if it is over the counter medicine or the prescriptive! Most of them even don’t feel it necessary to tell about right dose to the patient. Shopkeeper gets his profit and patient; his medicine. Both the parties are pleased why would they care about the consequences- the antibiotic resistance.

Out of thousands of pharmacies in Nepal, only few hundreds are currently run by pharmacists or assistant pharmacists. Remaining are run by “aushadi byabasahi”. This means the majority of our pharmacies are in the hands of someone who is completely profit oriented and knows very little (only names and some uses) of some medicines. Antibiotics are expensive and offer greater profit margin. So, why wouldn’t the shopkeeper sell that medicine to anyone who comes asking for it? Why would he bother asking for prescription or telling about the consequences? Similarly, companies offer an attractive and mouthwatering commission to the doctors to prescribe antibiotics. The more you prescribe, higher is your commission. Therefore, even higher dose antibiotics and also the reserved group antibiotics are found being randomly prescribed. Use of antibiotics has become similar to using sugar in the tea! We can see at least an antibiotic in every single prescription today. As a result, all the antibiotics that we currently have are already exposed and bacteria’s have developed resistance against most of them. Nosocomial Pneumonia has become very common .It is such a situation where a patient is infected by antibiotic resistance species of bacteria and he/she has to die because of this infection rather than the disease they originally had.

Thus, this random practicing, prescribing and selling of antibiotics has led us to a catastrophic antibiotic resistance situation. Today, we have reached in such a situation where if you go the hospital,the infection acquired in the hospital will kill you and if you don’t your disease will kill you.  A significant number of premature deaths occur every day in our hospitals due to conditions like hospital acquired pneumonia, lower respiratory infections, urinary tract infections caused by resistant bacteria. I am afraid, if any new epidemic strikes Nepal in a near future, the numbers of death may be in thousands. It is because those antibiotics which are protected as reserved antibiotics by the government are already being prescribed randomly and they may or might have gained resistance. If the present scenario continues, the day will come when people will start dying because of minor infections on cut and burn areas.

picture: www.hse.ie