Early Times Report
NEW DELHI, Aug 23: Amid a spike in monsoon-related illnesses, doctors have said people should avoid self-medication with antibiotics as fever does not automatically mean a bacterial infection and that indiscriminate use of the drugs can contribute to antimicrobial resistance. Physicians stressed that fever is a symptom rather than a diagnosis and could be caused by viral infections, dengue, malaria, typhoid and several other conditions. Treatment should be guided by the clinical assessment, duration of illness, associated symptoms and appropriate diagnostic investigations, wherever indicated. “Patients frequently come to us after taking multiple medicines, including antibiotics, simply because they have developed fever. Fever by itself is not an indication for an antibiotic. The first step is to determine what is causing the fever “ Dr Sujeet K Choudhary, Chief Medical Officer, Internal Medicine, Sitaram Bhartia Institute of Science and Research, said. Antibiotics are designed to treat bacterial infections and have no effect against viral illnesses, he said Taking them unnecessarily can cause avoidable side effects and, more importantly, contribute to the emergence and spread of antimicrobial resistance (AMR), ”making infections harder to treat in the future. Dr Neeraj Nischal, Professor in the Department of Medicine at AIIMS, Delhi, said symptoms of several monsoon-related illnesses can overlap, making it important for people to avoid self-diagnosis and self-medication. “Fever, body ache, headache, weakness and gastrointestinal symptoms can occur in a number of infections. Management should be guided by the patient’s clinical condition and, where required, appropriate investigations,” Dr Nischal said. He also cautioned people against using leftover antibiotics from previous prescriptions or taking antibiotics prescribed for someone else. “Antibiotics should not be started, stopped or modified without medical advice. People should not change the dose, duration or frequency on their own. If symptoms persist, fail to improve or worsen, the patient should be reassessed rather than simply adding another antibiotic ,” Dr Nischal said. Dr Mayank Uppal, senior consultant, Internal Medicine at Sitaram Bhartia Institute of Science and Research said antimicrobial resistance was increasingly making treatment of infections more challenging. “Antibiotic resistance is not a future threat; it is already affecting clinical practice. When antibiotics are used unnecessarily or incorrectly, they exert pressure that allows resistant organisms to survive and spread,” Dr Uppal said. He, however, stressed that the answer was not to avoid antibiotics when they are genuinely required. “Antibiotics remain lifesaving medicines. The objective is not to reduce their use indiscriminately but to ensure that the right patient receives the appropriate drug, dose and duration based on the clinical situation,” Dr Uppal said. The Indian Council of Medical Research (ICMR) guidelines on antimicrobial use emphasise appropriate antibiotic selection and caution against indiscriminate empirical treatment, particularly when a bacterial infection has not been established. |