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Antibiotic indulgence: Misuse of a miracle

Millions of children die of pneumonia, typhoid or diarrhea every year, a large number of them due to antibiotics-resistant super bugs. And quick fix doctors, guilty of doling out wide-spectrum antibiotics for prolonged periods, are aiding the silent epidemic, reports Vipul Mudgal.

entertainment Updated: Jun 07, 2012 17:01 IST

French actor Guillaume Depardieu was forced to have his leg amputated in 2003 when an avoidable infection became life threatening. The famous son of a legendary father, Gerard Depardieu, Guillaume got the infection after a motorcycle accident seven years earlier.

Sunday Telegraph quoted Guillaume saying that amputation became inevitable because excessive use of antibiotics made him too weak to fight infections, after 17 operations on his leg. Within months, Jean-Luc Lagardere, the billionaire head of the media and defence conglomerate, Matra Hachette, died ostensibly of a similar infection, following a relatively benign operation.

The two cases brought antibiotic resistance into media focus in Europe where it continues to be a hot topic. But in India, where millions of children die of pneumonia, typhoid or diarrhea every year, a large number of them due to antibiotics resistant super bugs, the tragic trend is yet to provoke a nationwide policy debate.

According to Boston-based Alliance for Prudent Use of Antibiotics (APUA), the problem is compounded by quick fix doctors, guilty of doling out wide-spectrum antibiotics, for prolonged periods. Venezuelan medical scientist Dr Anibal Sosa of APUA told Hindustan Times that injudicious use of antibiotics, coupled with a surfeit of super bugs in hospitals, could easily be one of the biggest killers in the developing world.

The silent epidemic

Surveillance organisation GAARD or the Global Advisory on Antibiotic Resistance Data calls the phenomenon a “shadow epidemic.” It estimates that millions of South Asians infected by TB, gonorrhea, hepatitis, AIDS and a host of other infections succumb to super bugs transmitted in hospitals.

Swedish immunologists Otto Cars and Per Norberg warn that malnourished children, in whose numbers India tops the world, are as vulnerable to super bugs as cancer or AIDS patients due to an undermined immune system.

In a rare case in Delhi, renowned journalist Praful Bidwai is suing a leading hospital for messing up a post-fracture infection he believes he picked up at the hospital more than a decade ago. Bidwai told HT that he was given a cocktail of very toxic drugs without ascertaining the bacteria-type through pathological tests. Many leading doctors here privately admit that “staph” infections that are resistant to usual antibiotics are rampant in Indian hospitals and the poor patients have no way of knowing the whole truth.

Why are bacteria becoming resistant?

Alexander Fleming’s chance discovery of penicillin in 1928 generated a sense of universal optimism that mankind was winning the war against sickness. But even Fleming warned then that some strains of staphylococcus aureus remained unaffected.

Antibiotics do kill or inhibit the growth of susceptible bacteria but some surviving bugs develop the ability to neutralise their effect. Bacteria also acquire resistance through mutation of their genes or transfer of DNA codes from brother bugs, a process that can only be explained as nature’s defence mechanism.

Development of stronger antibiotics has not made a big difference. That is why the new thrust of all medical campaigns in the US and Europe is on checking their injudicious use. Successive World Health Reports show increasing mortality due to preventable infections. This depressing trend is bound to continue, as the stories below show, if interventions are not made at the level of drug policies, improved research and effective prevention strategies.