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We humans think of ourselves as intelligent and rational. We have successfully evolved, subdued the lower animal species and conquered the world. We could not be more wrong.
The medical community thought that it had finally conquered bacteria and infectious diseases after Alexander Fleming discovered penicillin in 1928. Doctors couldnâ€™t have been more naive.
Bacteria have offensive, defensive, stealth fighter and commando manoeuvres that no human army can match. They hide in areas like pus, thick layers of skin, bone and cartilage that antibiotics can’t penetrate. They adapt and change faster than a speeding bullet. They are not bound by narrow-minded considerations like race or ethnicity; they join forces enthusiastically with bacteria of other species. When all else fails they copulate, and during the process, exchange genetic material that provides resistance to antibiotics.
Immunisation is a powerful weapon that boosts the body’s own defence mechanism
Unfortunately, human beings are collaborating in this warfare, unwittingly aiding bacterial victory. Fifty per cent of the total antibiotic production is used for animals. Farmers rearing cows, sheep, goats, chicken and fish often use animal feed fortified with antibiotics to keep their livestock healthy. Sometimes the antibiotics are administered as regular supplements. These antibiotics contaminate the environment. The sub-optimal quantities administered to the animals arenâ€™t enough to kill all the targeted bacteria. Genetic mutations occur and resistant bacteria emerge. These eventually find their way into the human community. Treatment with the antibiotic recommended for that particular infection will then fail, requiring more potent and expensive drugs.
Sometimes doctors may be at fault. They may fail to calculate the correct dosage, particularly in case of children where it is based on the body weight. Sometimes the dosage intervals may be incorrect and the next dose is administered later than required, after the drug has been totally eliminated from the body. Also, in the absence of investigations, the chosen antibiotic may be inappropriate for that particular infection. Instructions to patients may be incomplete, without specifications on whether it is to be taken before or after food, as food may help or impede absorption.
Surgery or ICU admissions raise the spectre of post operative infection, although this should not be the case if proper sterilisation techniques are followed. To prevent this, antibiotics are administered prophylactically prior to, during and after surgery. This aids the development of resistance, as the targeted organism may not be the same as the infecting one.
Often patients, too, have unrealistic expectations. They are not willing to accept the fact that antibiotics do not work against viral infections. They find it difficult to follow a â€œwait and watchâ€ policy. They fail to realise that it is antipyretics (like paracetemol) and not ad hoc doses of antibiotics that reduce fever. They tend to â€œdoctor shopâ€ till they find someone who will prescribe the antibiotics they want.
Diseases that compromise host immunity allow bacteria to gain a foothold and thrive. In such a scenario, higher and longer doses of antibiotics have to be used. Some of these diseases, like diabetes, can be controlled with a little effort, diet control and exercise.
Our drug control policy is somewhat lax. Pharmacies freely dispense unprescribed schedule H antibiotics in irrational combinations OTC (over the counter). Although this is illegal, their activities cannot be faulted, as â€œsupply meets demand.â€
As educated responsible citizens, we should not self medicate and perpetuate this menace. Immunisation is a powerful weapon that boosts the bodyâ€™s own defence mechanisms. As soon as the invading bacteria launch an attack, the sentries and foot soldiers (white blood cells and immunoglobulins) sound the alarm, engulf and annihilate the bacteria. Immunisation is available against diphtheria, tetanus, pertussis (whooping cough), H. influenzae (meningitis, ear infections, bronchitis), Pneumococcus (pneumonia, ear infections, meningitis), Meningococcus (meningitis) and typhoid.
Researchers are trying to discover newer and stronger antibiotics to combat the menace of bacterial resistance. They cost crores to discover and test before they can be finally used. We therefore need to conserve and use what we already have. Once the rate of discovery ceases to keep pace with the mutation in the bacteria, we have lost the battle to the microbes.
So, I strongly believe that people should rely more on alternative therapy like yoga,meditation,herbal medications etc. for maintaining a good health unless there is any medical emergency .