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ANTIBIOTICS : WHY and WHEN not to use?

Bacteria  war
We faced two major world war in 19 th century.The second world war being deadliest with over 70 million fatalities. These  war took millions of lives , thousands of city were burned to the ground. It took many decades for those nation to rehabilitate and stand up again. The time has come again and we might need to be ready to face another war.
This war wont be against big nations for the territory or the pride. No armies , nukes , ammunition and the atom bombs. Rather , it might be against the tiny tiny bacteria ; which cant even be seen by our naked eyes. Yes ! And its all true.


We all know about antibiotics. They simply kill bacteria or inhibit its growth and save us from its harmful aspects. Before antibiotics were developed , lets say in  pre antibiotics world health care was not as promising as of now. People died of abrasions, burn , cut, infections. Then in 1928, Alexander fleming discovered miracle substance called penicillin. Then the health care took new horizon . This made everything possible in the modern health care. From sore throat to heart transplantation , from hand wash to hygienic food on our plate , antibiotics are used.
     We fought with antibiotics for our good and blessed  to save lives , reduce mortality , increase life expectancy . Antibiotics are confidence to our life , nobody will drive a car with so much confident if we did not have this miracle drug. A simple road traffic accident was enough to kill a person in pre antibiotic era.
      If there happened a robbery in our house through the window then we put stronger window , strengthen our security.Antibiotics does the same , When we attack antibiotic, they can know how and where we attacked and change themselves instantly so next time they can survive the attack. This survived bacteria are called resistant bacteria . We make new drugs, bacteria develop new resistance .They become more powerful and more difficult to kill and are then called superbugs.It takes a lot of time for us to make newer antibiotics . But bacteria can become resistant to our drug in very short time. Now , we have many antibiotics but most  bacteria has already developed resistance to them. The resistant strain are always a threat and most of the big pharmaceutical companies has stop making newer antibiotics due to time consuming , ridiculously expensive and very difficult process to get approval by the drug administration.
        A study estimated that within 2050 , 10 million people will die of superbugs. And the rate will increase exponentially in coming days. In the 1346-1353 we lost 75-200 millions of people to the plague or black death . Same might repeat again if we do not do something now.
The resistance usually develop due to irrational use of these drugs. Lets say for prescribing Azithromycin for normal cold flu. or , not completing the dose of antibiotics. Vandalism use of antibiotics in the farms and poultry, these all develop resistance. We are solely responsible for the present scenario. We are responsible for millions of people to die of the superbugs in near future.
   If we suppose drugs as the currency then antibiotics are the strongest. But we misused, we spent it haphazardly and now we are running out of their spectrum.
After antibiotics no longer works , we go to the post antibiotic era. Lets look what we will face when we will no longer have working antibiotics. We wont just lose ability to treat infection ; the obvious one. But also to treat cancer , organ transplantation , open cavity surgery . The surgery on body parts which naturally harbours large number of normal flora like guts , bladder , genitalia. We wont have implants like new heart valves , new hip knee. We wont be able to get a tattoo too.
We would lose todays easy and hopeful procedure of child birth : perviously every 5 women out of 1000 died of childhood . Out of 10 pneumonia patients 3 died.
 This wont leave food and agriculture sector untouched. The crop production goes down , ultimately hiking the price very high. Industrial meat production routinely uses antibiotics , ultimately sicken the animal and decrease in the production.

We have come this far not only to come this far. So we always have a hope. Antibiotic resistance is a natural phenomenon but we can surely minimise the way its speeding dramatically . Especially in the third world nations like ours antibiotic are still over the counter drug. Firstly , these needs to stop. People are buying antibiotics for normal illness and stopping medication as soon as they feel fine. This incomplete dosing has contributed mostly to their resistance. We are here doctors and to become one  ; here is what we can do.we should not prescribe antibiotics until they are truly necessary. All antibiotics should be prescribed only after testing what should the patient have. A study states that half of all antibiotics prescribed unnecessarily like for viral infection. We can also prevent infection in the first place by public health  , like hand wash , vaccination and immunisation.
The government agencies can play a vital role. National strategy can be made , surveillance has to be done , quality checks.  Most importantly, education can be spread among the public and responsible personnels. The government must fund researchers and projects to develop new antibiotics. This is a global concern , nobody never know how fierce it could really get. Global partnership is necessary.
If we wont take measures now , we will surely fail to use this miracle drugs to keep with us . Surely, this will be lose to all of us . Apart from losing historic scientific discovery , we will have to doubt about our existence too.
  So , its upon us to save this nobel drug or let it go. Time is running . If we want our save our kind then we have to start acting.

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