Hyderabad: The overuse of antibiotics leads to severe public health issues, including antimicrobial resistance, increased healthcare costs, reduced antibiotic effectiveness, the spread of resistant pathogens in agriculture, and the risk of untreatable infections, highlighting the need for judicious use and education on antibiotic overuse, say nephrologists.
Uncertainties about their use, overprescription, incomplete treatments, a lack of regulation, agricultural practices, public ignorance, and inadequate drug development are just a few of the factors that contribute to the misuse and overuse of antibiotics, which in turn fuels the global crisis of antibiotic resistance and public health threats, they point out.
Internal organs such as the kidney, liver, and nervous system suffer the most due to irrational antibiotic usage, warn nephrologists.
Among these, kidney damage due to inappropriate use of antibiotics is the most common, they point out.
Dr MV Rao, nephrologist, the Asian Institute of Nephrology and Urology (AINU) in Hyderabad said that the greatest culprit, which is widely prevalent in India, is the sale of antibiotics without a prescription, leading to their overuse and misuse.
"The widespread overprescription of antibiotics and the common practice of not completing the full course of antibiotics significantly contribute to kidney damage and the rise of antibiotic-resistant infections,” said another nephrologist Dr PS Vali.
"Certain antibiotics, particularly when used inappropriately or in high doses, can cause direct damage to the kidneys. This is particularly concerning in individuals with pre-existing kidney conditions or genetic predispositions. This is the case with some antibiotics, such as Amikacin or Gentamycin,” said Dr B. Srikanth.
Due to their unique genetic makeup, some individuals are prone to unusual hypersensitivity reactions in the kidney when confronted with antibiotics from the penicillin group, such as amoxicillin.
Another concerning outcome is the development of life-threatening urinary tract infections due to multidrug-resistant microbes that can mix up with the blood in no time from urine and result in blood sepsis.
Such infections lead to a condition known as acute kidney injury, where the kidneys shut down within hours as the septic blood laden with these bugs floods the kidneys and chokes their filters.
Nephrologists have underlined the need to take various measures to safeguard the community from the ill-effects of the irrational use of antibiotics. They say it's essential to boost public understanding about their correct usage.
They say antimicrobial stewardship programmes are required to enhance the effective use of antimicrobials, including antibiotics. The goal is to improve patient outcomes, minimise microbial resistance, and prevent infections from drug-resistant organisms.
These programmes guide healthcare professionals in choosing the right antibiotic, dosage, duration, and administration method. The experts have also called for implementing strict regulations against selling antibiotics without a prescription.
Healthcare providers should adhere to established national and international guidelines for antibiotic prescriptions. This involves avoiding unnecessary prescriptions and ensuring the correct dosage and duration.
According to nephrologists, there is also a need to focus on research and development of new antibiotics that can reduce the overreliance on existing ones, thereby decreasing resistance risks.
These measures call for a collaborative effort from healthcare professionals, policymakers, the pharmaceutical industry, and the public. It’s also important that these strategies are customised to meet the specific needs and conditions of different regions and healthcare systems.
With agency inputs