Objective: To discuss and analyze whether "Western" ideologies and cultural practices of overusing antibiotics are leading to an emergence/re-emergence of infectious diseases and if it is so to find out remedial measures to curb the situation.
Introduction: The emergence of human immunodeficiency virus (HIV) infection causing the disease acquired immunodeficiency syndrome (AIDS) and its killer sequels have brought into focus the emergence and re-emergence of infectious diseases…
Further, all three were amenable to antibiotics/anti-fungal drugs and easily managed. The emergence of resistant and virulent strains of organisms causing them juxtaposed with the acutely debilitating AIDS is making them virtual killer diseases.
Staggering Statistics: According to a press release by the American College of Physicians in July 2000, the annual consumption of antibiotics in the United States was $ 15 billion and the cost of treating antibiotic resistant diseases was at least $ 1.3 billion. Even if the consumption were to grow at a modest 10% every year, the figures would be a staggering $ 24 billion and $ 2.09 billion in 2005. There were, in one year, 51 million visits to physicians for cold, upper respiratory tract infections and bronchitis and in these visits 50%-66% were prescribed antibiotics even though these conditions usually do not need antibiotics. It was possible that the physicians prescribed more powerful antibiotics than needed or prescribed antibiotics for viral infections, for which they were useless. The report opines that behind the doctors stands, "an array of forces that keep the antibiotic consumption high". They include: patients' hunger for magic remedies, only which satisfied them that the doctor was really treating them; a system where novices were in charge of prescribing drugs; direct to consumer advertising by drug companies to induce patients to demand newer, costlier antibiotics where older, generic drugs would have worked as well or no drug was required and most importantly a health system that set targets to its physicians to see patients by the hour, reduce the number of return visits and get the patients out of the hospitals faster. (Misuse of Antibiotics Fueled by Culture and Economics. 2000) This is a damning indictment on the system not by a wayward whistle-blower but introspection by the American College of Physicians on the state of healthcare today.
According to a report broadcast by the Australian Broadcasting Corporation the Australians consumed more than 200 tonnes of antibiotics in the year 2000-01, often for common viruses, which do not respond to drugs. According to a report prepared by the National Health and Medical Research Council of Australia, 50 % of the 24 million prescriptions written by the doctors in that year were unnecessary. (Over consumption of antibiotics.2001)
Culture 'psyching' consumption: One of the principal reasons behind the indiscrimate use of antibiotics seems to be the role culture plays in the relationship between the patient and the doctor and the methods adopted to treat diseases. While the environment determines nosology or disease pattern of a society, it is the socio cultural milieu that determines its constituents' response to disease.
The first component in the social interplay that approaches illness and its response is the patient. From the patient's point of view the prescription of an antibiotic seems to imply three things: one, that the patient has an illness; two that a diagnosis has been made and ...
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