Antibiotic use has become extremely rampant and with that, there has been a rise in antibiotic resistance. The Indian Council of Medical Research (ICMR) on Antimicrobial Resistance Research and Surveillance Network recently released its 2023 annual report which reviews the trends of antimicrobial resistance (AMR). The report highlights the increase in antibiotic resistance in diseases like urinary tract infections (UTIs), blood infections, pneumonia and typhoid. This has eventually made treating these illnesses difficult.

The ICMR shows a rise in antibiotic resistance and a decrease in the effectiveness of key antibiotics. Antimicrobial resistance (AMR) happens when germs develop the ability to defeat the drugs designed to kill them, says the Centers For Disease Control and Prevention (CDC). These are usually antibiotic drugs that are prescribed.

The World Health Organisation (WHO) says that AMR is one of the world’s most urgent health problems. It has directly led to the death of nearly 1.27 million people and contributed to the death of 4.95 million worldwide in 2019.

In an Instagram post, Dr Chhaya Shah shared the most commonly misused and overused antibiotics in India. She says that the two most commonly misused and overused antibiotics in India are Azithromycin and Cefixime. Azithromycin is also available as azithral, zithromax, azee, zathrin etc and Cefixime is available as Zifi, Taxim 0 etc.

Dr Shah says, “Azithromycin is commonly misused for sore throat, cough and cold. Cefixime is overused for any fever and even sore throat sometimes.”

She adds, “Azithromycin is misused because of its convenient dosage (once daily for 3 days). Cefixime is prescribed commonly by quacks possibly because it’s considered safe.” Dr Shah says that azithromycin has once-daily dose for just 3 days because of its long half life. This means it takes 3 days for half of the medicine to leave the body. It remains active in the body for a long time even after you have stopped taking it.

This means that the medicine remains in the body and environment for a long time in low doses and a consistent exposure to the antibiotic leads to germs getting used to this medicine. “As a result, the same germs which responded to Azithromycin earlier would now NOT respond any more to the same medication,” says Dr Shah.

Explaining it further, she said that “if these don’t respond to antibiotic, they may have the potential to hospitalise us or maybe even kill us.”

Speaking of Cefixime, she said that it is commonly indicated for dysentery and typhoid. But because of its misuse, even typhoid germs have become resistant to it. “As a result, the once easily treatable Typhoid now requires higher antibiotics or hospitalisations. All because of misuse, overuse or underdosing or using it for just 1-2 days,” adds Dr Shah.

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