Indiscriminate use of antibiotics in India is making common infections like urinary tract nfection (UTI) deadly. Urologists say five out of every 10 UTI patients are now requiring injectable drugs and, in some cases, even that fails to help.
We are forced to use old injectable antibiotics with known toxicity to kidneys, for example Colistin, to save patients with multi-drug resistant UTI," Dr Anup Kumar, professor and head of the urology department at Safdarjung hospital, said.
UTI is one of the most common bacterial infections that affect one or more parts of the urinary system kidneys, ureters, the bladder and the urethra. It is more common in women than men.
Kumar said that if steps are not taken to strictly regulate and monitor prescription and sale of antibiotics immediately , the bacteria triggering UTI will turn resistant to even the remaining drugs. People may die of UTI," the Safdarjung doctor added. Urologists at Sir Ganga Ram, Max and BLK-Max Super-Specialty hospitals have also confirmed the trend of rising drug resistance in UTI cases.
Four to five patients suffer kidney failure due to UTI infection each year. It is either caused by the infection itself or heavy dosage of antibiotics administered to treat them, Dr Anant Kumar, chairman of the urology and kidney transplant department at Max Saket, told TOI.
According to Dr Amrendra Pathak, senior urology consultant at the Sir Ganga Ram hospital, most UTIs are caused by gram negative bacteria such as EColi. Till about 10 years ago, most UTIs were treatable with oral antibiotics. It was less toxic and easy on the pocket, too. But due to drug resistance many patients have to be admitted and they are put on injectable drugs that are five to six times costlier, he said.
The doctors say self-medication is the biggest cause of drugresistant UTI. Many people take antibiotics on their own if they experience burning sensation while urinating. Many doctors who are not even specialists also prescribe antibiotics without conducting a urine culture. All this triggers resistance, said an expert.
Dr Aditya Pradhan, Senior Urology and Kidney Transplant Consultant at BLK-Max Super Speciality Hospital said there are three to four designated antibiotics for treating uncomplicated UTIs.
Powerful antibiotics ought to be saved for treating complicated ones, or UTIs in patients who are also suffering from other conditions like diabetes.But many physicians use the latter for quicker results, which leads to development of drug resistance, he said. Women are at higher risk of UTI due to shortness of the fe male urethra, which is 1.5 inches long compared to 8 inches in men. Frequent or recent sexual activity and allergies are other common causes. Most men become susceptible to UTI after crossing 50, when they begin to develop prostate problems.
Recently, the World Health Organisation came up with a list of 12 antibioticresistant priority pathogens. E-Coli, a common cause of UTI, were one of them. The list was drawn up to promote research and development of new antibiotics adding that the move was part of efforts to address the problem of growing global resistance to antimicrobial medicines.
Antibiotic resistance is growing and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we urgently need are not going to be developed in time," said Dr Marie-Paule Kieny , WHOs assistant director-general for health systems and innovation.
In the past decade, no new antibiotic has been developed globally. Experts say pharmaceutical firms are focusing less on research for newer broad spectrum antibiotics as their shelf life is lesser compared to drugs meant for chronic illnesses.A new antibiotic may be used for limited period but diabetes drugs will be used for years by patients. Antibiotic may become useless if bacteria develops resistance to it. This is a major cause of slowness in drug discovery to fight antibiotic resistance," said an expert.