Antibiotics for fever, cold and diarrhoea? Just stop popping them at will or picking them up from the drug store

So what’s causing drug-resistance? The first reason is the rampant availability of antibiotics over the counter and our habit of popping them at the slightest onset of fever. Instead of symptomatic treatment, people rush to take broad spectrum antibiotics on their own. Often, they will coerce their neighbourhood doctor into prescribing a course. If they don’t, they procure them from a pharmacist, who has no scruples selling them. I blame such medical practitioners for giving in to such demands. So many times I have to tell my patients to take paracetamol for fever, body ache and headache. But most of them then self-medicate with ibuprofen and diclofenac. When one does not know the cause of a fever, paracetamol is really the safest medicine. Then you can consult your doctor who will advise you on the tests to be taken. However, one should not overdo paracetamol as well. The dosage depends on the age and body weight of an individual, but an average adult may have the 650 mg tablet every six hours, meaning four tablets a day. Normally, any fever, including that caused by dengue, should resolve in three to five days.

What are the most commonly misused drugs? I have found quite a few recommended arbitrarily.
Azithromycin — Fever, throat pain, cough in adults and children.
Amoxycillin — Common cold, fever, ear pain, throat pain and cough
Amoxycillin (Clavulanic acid combination) — fever, throat pain and cough in adults
Ciprofloxacin, Ofloxacin — Urinary infection and diarrhoea
Cefixime — Fever, throat pain and cough
Indiscriminate use and prescription of broad-spectrum antibiotics is the worst culprit. Even the commonly used drugs for diarrhoea such as Norflox or Oflox are no longer as effective because of acquired resistance.

The other common mistake we make is hoarding antibiotics on the pretext of travelling abroad or sending them to our families living there. Since antibiotics are not available over the counter in these Western countries, we just perpetuate a culture of popping them as a quick fix in communities living there.

The third most common reason for antibiotic resistance is a lack of compliance to clinical protocols. People decide to stop their antibiotics mid-course the moment they feel better. The greatest consequence of non-compliance and indiscriminate use of antibiotics is drug-resistant tuberculosis (TB), which has assumed crisis-like proportions in India.

The fourth reason is a poor medical hygiene protocol in hospitals and institutions to avoid spread of the superbugs from patient to patient. This is the primary reason that drives up the numbers of hospital-acquired infection. There must be proper sterilisation protocols, particularly those of medical instruments and shared spaces. The lowest level healthcare professional should be suitably masked up, gloved and clothed in sterilised gowns. Hand hygiene and sanitation protocols are the most important way of preventing the spread of infections, including antibiotic-resistant infection. Make sure that your vaccinations are up to date. But we must build an effective communication strategy on a war footing to educate patients about the dangers of misuse.