Doctors Caution Against Indiscriminate Antibiotic Use As Monsoon-Related Illnesses Rise

NEW DELHI : 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.

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.

“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.

Doctors said patients with persistent or worsening fever, breathing difficulty, altered consciousness, severe dehydration, persistent vomiting, bleeding or marked weakness should seek prompt medical evaluation.

People with underlying illnesses, older adults, young children and those with compromised immunity may also require earlier assessment, Dr Asuri Krishna, professor in the department of Surgery at AIIMS, Delhi said.

Another concern was the tendency among patients to judge the severity of an infection solely by the intensity or duration of fever and seek antibiotics when symptoms did not improve immediately, he highlighted.

“Fever for a few days does not necessarily mean that a stronger antibiotic is required. In many viral infections, supportive treatment and adequate hydration are the mainstay, while persistent or worsening symptoms need a fresh clinical assessment to identify whether the diagnosis needs to be revisited,” Dr Krishna said.

Dr Choudhary also cautioned against making treatment decisions based solely on rapid diagnostic tests or information obtained online.

“Diagnostic tests have to be interpreted in the context of the patient’s symptoms and examination. A test result in isolation should not become a reason to start or stop an antibiotic. What is important is a proper clinical assessment followed by appropriate investigations when indicated,” he said.

Avoid taking antibiotics without medical advice, and consult a qualified healthcare professional when fever is persistent, severe, recurrent, or accompanied by concerning symptoms, Dr Choudhary said.

Dr Krishna said preventing antimicrobial resistance requires responsible prescribing as well as greater awareness among patients.

Patients should understand that receiving an antibiotic is not necessarily a sign of better treatment, he said.

In many cases, the safest and most appropriate approach is careful observation, supportive treatment and reassessment if the condition changes,” he said. (Agencies)