Is there anyone who does not take any medicine? At least pop a Pan D before heading to a wedding feast?” A doctor asked an audience that smiled knowingly. The interaction was taking place at the Biomedical Science Centre at IB Block on the widespread habit of taking medicines without proper consultation, on the rational and irrational use of drugs and on antibiotic resistance.

“The WHO in 1985 defined the rational use of medicine as when individual patients receive appropriate, individualistic medicines tailored to their clinical needs in doses that meet their specific requirements. This includes the right selection of medicine, procurement, storage, prescribing, dispensing, monitoring, and feedback to ensure drug safety and efficacy,” explained Suhrita Paul, then the officer on special duty at the state department of health and currently the principal of Barasat Medical College and Hospital.

The FE Block resident highlighted the consequences of incorrect doses, improper administration, and the dangers of drugs with unproven efficacy such as antioxidants, vitamins, tonics, mental boosters, memory enhancers, or drugs with uncertain safety statuses, like anabolic steroids. “Medicines should be taken only when there is an actual requirement. There must be proper diagnosis and adequate monitoring of the patient,” she said.

Paul cautioned about the co-administration of drugs, explaining how sometimes people need to visit different specialists for different complications. “But a lack of co-ordination in treatment can lead to the different drugs having reactions in the body, especially in the geriatric age group. It is important to keep track of the drugs prescribed by other doctors to avoid this. Some people do not complete their doses due to lack of awareness, information, and funds. This is also harmful,” she explained.

Antimicrobial susceptibility testing in a petri dish The Telegraph

Do not self-medicate

Paul repeated a warning made by Alexander Fleming, who discovered the first antibiotic penicillin in 1929. “At his 1945 Nobel Prize ceremony, Fleming had said that a time may come when penicillin can be bought by anyone in shops. Then there is a danger that the ignorant may easily under-dose himself, and by exposing his microbes to non-lethal quantities of the drug, make them resistant,” she noted.

Before prescribing antibiotics, it is essential to consider whether they are necessary, as not all fevers or infections are bacterial. The choice of the most appropriate antibiotic, the correct dose, frequency, route, and duration are crucial for effective treatment.

Bacteria become resistant through various changes, often linked to the overuse of antibiotics in animals. Drug-resistant bacteria can spread to humans via food, the environment, or direct contact, with poor hygiene and unclean facilities exacerbating the problem.

Effective measures include surveillance to prevent misuse, increased public awareness, vaccination, infection control, stringent policies, and the preference for rapidly acting, narrow-spectrum antibiotics.

“Antibiotic resistance is an urgent global health threat,” said Paul. “To become an antibiotic guardian, everyone has to play a role. Political will and enlightened bureaucracy alone are not enough."