Avoid antibiotics for seasonal cold and cough, says Indian Medical Association amid rising cases

IMA has warned against overuse and misuse of antibiotics for viral cases.
| Photo Credit: The Hindu

In response to the rising cases of cough, cold and nausea across the country, the Indian Medical Association (IMA) has advised against an indiscriminate use of antibiotics like Azithromycin and Amoxiclav to alleviate symptoms.

The IMA noted that most cases of seasonal cold and cough — resulting in nausea, sore throat, fever, body ache and diarrhoea in some cases — currently being reported are due to the H3N2 influenza virus. While the fever should last up to three days, the cough can continue for three weeks. Viral cases have also surged due to air pollution, they noted.

Antibiotics for seasonal colds are ineffective; their overuse and misuse can result in antibiotic resistance which can make bacterial infections a public health threat. There is a trend where physicians prescribe antibiotics despite patients not exhibiting relevant symptoms, the IMA said.

“Right now, people start taking antibiotics like Azithromycin and Amoxiclav etc, that too without caring for done and frequency and stop it once start feeling better. This needs to be stopped as it leads to antibiotic resistance. Whenever there will be a real use of antibiotics, they will not work due to the resistance,” IMA said in a statement.

Instead, physicians should practice “self-control” and “regulation”, and apply medical therapy that affects the symptoms in question. Good hand and respiratory hygiene, avoiding crowded places and taking vaccines is further recommended by the IMA.

“It is necessary to diagnose whether the infection is bacterial or not before prescribing antibiotics,” the association noted.

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“It is necessary to diagnose whether the infection is bacterial or not before prescribing antibiotics,” the association noted.

They took the example of azithromycin and ivermectin usage during COVID-19 to allude to the pitfalls of over-prescribing antibiotics without sufficient evidence.

Antibiotics sale soared during the pandemic in India, where they where frequently being used to treat symptoms like cold and cough, according to a 2021 research led by Washington University School of Medicine in St. Louis. 

“Antibiotic resistance is one of the greatest threats to global public health,” said the study’s senior author, infectious diseases specialist Sumanth Gandra, MD, an associate professor of medicine and an associate hospital epidemiologist at Barnes-Jewish Hospital. “Overuse of antibiotics lessens their ability to effectively treat minor injuries and common infections such as pneumonia, which means that these conditions can become serious and deadly. Bacteria that have become resistant to antibiotics don’t have boundaries. They can spread to any person in any country.”

A 2019 study also found that AMR is estimated to cause 10 million deaths annually by 2050. 

India’s antibiotic consumption is a worrying trend among health practitioners and activists. Globally, India tops the list of countries with the highest antibiotic consumption, and the highest antimicrobial resistance (AMR) cases. A study published in  The Lancet Regional Health—Southeast Asia found the prevalence of a high volume of broad-spectrum antibiotics, such as Azithromycin, and unapproved formulation of drugs.

Key factors that have allowed unabated usage of antibiotics include lack of awareness among patients and practitioners, unrestricted drug manufacturing, and tepid regulations around antibiotic production and distribution, researchers have previously said.