Sunday, January 8, 2012

Going back to dark ages?

It was in the twenties of last century that antibiotics were discovered. First came the sulfa compounds and then came that remarkable antibiotic penicillin and then many more. In less than 90 years the microbes have learnt to live and occasionally thrive in the presence of these antibiotics. The last shock of the discovery of ESBL [Extended spectrum betalactamase resistant] was some years ago and now comes the report not of multi drug resistant but all drug resistant Tubercle Bacillus which causes tuberculosis. This is like icing on the cake or to be more precise adding insult to injury.

This means that in the near future if you get tuberculosis there may be no drug to cure you and in likelihood you will die. How you will die depends on the organ that is infected. TB germ can infect all organs from head to foot.

Human arrogance that he is the sole lord and master of this earth is responsible for this state of affairs. Microorganisms have been in existence for many millions of years before multicellular organisms AND other forms of life including humans evolved. They are self contained remarkably efficient life units who have learnt to survive in extreme adversity. We, primarily doctors believed that we can win the battle of infection by using these antibiotics. We used these liberally and indiscriminately and are still using them. Most infections are self limiting and antibiotics are redundant. But it has been common practice to use these in all infections trivial or otherwise. To give two examples. One is Staphylococcus. This is the germ which causes the common furuncles and abscesses. These, left alone will burst and heal or can be drained by a simple cut. But we routinely use antibiotics and now this organism has developed multidrug resistance. Another one is a germ called E-Coli. This one has a special liking for our urinary tract [especially women’s].This one too has become multidrug resistant. These two have become major headaches for us doctors and now are no longer simple germs that got killed by one or two doses of antibiotics. They have become killers.

If one considers one out of one hundred Indians have TB, then imagine the havoc this all drug resistant TB germ is likely to cause?

We are heading towards the dark ages of pre antibiotic days and we may have to look up and see how the physicians of those days managed their patients!

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