Half of all antibiotics sold in pharmacies are dispensed without a doctor’s prescription, and as a result the supply of drugs that work effectively against germs is shrinking. Ordinary antibiotics are already failing to work for surgical patients, who must now be given third-generation antibiotics — and in larger quantities than before.
The Directorate General of Drug Administration had directed that no antibiotic may be sold without a registered doctor’s prescription. Over-the-counter sales are being blamed, along with other factors, for antibiotics becoming resistant — that is, ineffective against bacteria. Most people who buy antibiotics on their own do not complete the course.
An article on the sale of antibiotics without prescription in the renowned medical journal The Lancet said that in countries where antibiotics are sold more freely without prescription, antibiotic use and resistance rates are comparatively higher. The World Health Organization has said that unless the over-the-counter sale and self-directed use of antibiotics can be reduced, it will not be possible to bring down antibiotic resistance.
Doctors say antibiotics keep people alive from bacterial infections. Almost every drug company in Bangladesh produces antibiotics, and company sales representatives coach sellers on how to use them to secure higher sales. Antibiotic sales have indeed risen — but because 99 per cent of these sellers are third-category pharmacists, they do not know the correct use of the drugs. They sell antibiotics according to customer demand purely for greater profit, the doctors say, helping the drugs become resistant and putting people’s lives at risk.
Doctors say most of these life-saving drugs have now lost their sensitivity to bacteria. Antibiotics that once cured a disease with a five-day or seven-day course no longer do so in five or seven days; larger doses must now be given, and for longer. This assessment was given by the eminent general surgeon Professor Dr Md Abdul Ohab.
Professor Dr Md Saiful Islam, chairman of the urology department at Bangladesh Medical University (BMU), said that because of antibiotic resistance, antibiotics were no longer working as before in urinary tract infections and various other conditions.
The prominent medicine specialist Dr Md Rafiqul Islam said antibiotics were not working as they once did, so treating diseases such as typhoid now required much larger quantities. Tuberculosis, he said, had become ‘super-powerful’, while common diarrhoea and dysentery could no longer be cured with the small doses used before.
Because antibiotics can be bought without a prescription, unqualified ‘quack’ practitioners hand them out even for a viral fever simply to make a sale; where simple paracetamol would suffice, at least one antibiotic is included. Antibiotic use is highest in small towns and rural areas. As rural people are not well-off, they rely heavily on local drug sellers when ill — and to them, the drug seller is the ‘doctor’. Village drug sellers are not even third-category pharmacists and have no basic training in medicines; their only qualification is some experience working at a drug shop, and company representatives teach them how to use antibiotics in order to sell the drugs.
On this, Dr Md Saiful Islam said that although Bangladesh has laws — particularly on antibiotic use — the lack of strict enforcement is rendering these life-saving drugs ineffective. A time will come, he warned, when no antibiotic will be available to cure people of bacterial infections or after operations, because the antibiotics in use, both old and current, are becoming resistant — that is, ineffective — while no new antibiotics are being discovered.
বাংলায় মূল প্রতিবেদন পড়ুন · Read the original Bengali report