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India is perhaps the worst abuser of antibiotics in the world. According to a latest paper published in Proceedings of the National Academy of Sciences (PNAS) , use of antibiotics in India went up 103% between year 2000 and 2015. All this, when multi drug resistance bacteria is in our hospitals, in our environment and it is spreading.
Why are we hearing so much about antibiotic resistance and post antibiotic era? Are we really that close to a medical nightmare? Do we understand bacteria and it’s ability to survive against our most potent drugs?
Dr Ramanan Laxminarayan, director with Centre For Disease Dynamics, Economics & Policy and a senior research scholar at Princeton University, explains.
We've had antibiotics only since 1942, when the first patient was treated with antibiotics. Antibiotics are very special drugs, because they kill bacteria in our body, without harming any human cells. It’s very special for a drug to be able to kill a biological organism without harming human cells.
One of the problems with using antibiotics is that they also kill a lot of bacteria that is not causing us any harm. Now overtime the bacteria that survive in our body know how to be resistant to antibiotics.
If you have a surgery, and your body is lying open, inevitably it will get infected regardless of how hygienic the operation theatre is. The only way to address is to have antibiotics. This is why the world is concerned about antibiotic resistance.
Our relationship to bacteria is very much like fish to water. We live in bacteria. They are in the air around us, on every surface.
If you removed all the bacteria from our body, we’ll be 4-5 kilos lighter. So the idea of us having a bacteria free future is not possible. Because bacteria we will die.
We need to use antibiotics appropriately so that we only attack bacteria that cause disease.
Penicillin was discovered by Alexander Fleming quite by accident in a petri dish where he found that a mould was inhibiting the growth of bacteria. There was no guarantee that if you had penicillin it would go in your body and kill the bacteria. It was sheer fluke. Fleming was lucky, we were lucky and we have antibiotics.
All antibiotics today are derived from the same 15-16 compounds.
The other reason why we are discovering so few class of antibiotics is because the cost of getting new drugs is very very high. Hundreds of millions of dollars and the pharmaceutical companies are not interested.
That’s why it’s important to not take antibiotics for granted. They are very special drugs and we’ve had them for only 70 years. This is probably the most valuable resource that modern medicine has had.
Back in the 1950s, some scientist in the US figured out quite by accident that chickens that were given antibiotics grew faster.
The reason is that antibiotics give us an advantage when our nutrition is not very good. But giving antibiotics to every single chicken on the planet, and there are billions of chicken, is a recipe for disaster.
There is a lot of research and development happening in new antibiotics. I am hopeful that there will be new drugs. But these will be very expensive. It may cost thousands of rupees. That’s the future. And it works for us only if we have money.
Our real hope is in controlling our use of antibiotics and we remain informed customers.
Editor: Kunal Mehra
Camera: Abhay Sharma
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Published: 20 Apr 2018,10:46 AM IST