By Dr. Juri B Kalita
Walk into many pharmacies across India, describe your symptoms, and you’ll likely walk out with antibiotics—no prescription required, no questions asked. It’s convenient, certainly. It’s also contributing to one of the most serious public health challenges of our time.
The ease of obtaining antimicrobials without proper medical consultation has created a culture of self-medication. Someone feels unwell, remembers that antibiotics helped previously, and simply purchases more. Or a family member shares their leftover medication. Or well-meaning advice from a neighbour leads to the pharmacy counter.
The fundamental problem is that most people cannot accurately diagnose their own infections. Bacterial and viral infections often present similarly—fever, fatigue, cough, general malaise. Yet antibiotics work only against bacteria. Taking them for a viral infection accomplishes nothing therapeutically while contributing to resistance. It’s applying the wrong solution to a misidentified problem.
Even when the infection is bacterial, choosing the appropriate antibiotic requires medical expertise. Different bacteria respond to different drugs. The wrong choice may be ineffective, may be unnecessarily broad-spectrum, or may carry side effects that outweigh benefits. Proper diagnosis often requires examination and sometimes laboratory testing—neither possible through self-assessment.
Then there’s the matter of dosage and duration. Antibiotics work by maintaining a certain concentration in the body over time. Taking too little allows bacteria to survive. Stopping too soon—a common practice when symptoms improve—leaves behind the strongest bacteria, precisely those most likely to have developed resistance mechanisms.
The pattern is troublingly predictable: someone feels better after three days of a seven-day course and stops taking the medication. The surviving bacteria, having been “trained” to resist that particular antibiotic, multiply. The next infection becomes harder to treat. Over time, across a population, this pattern erodes the effectiveness of entire classes of drugs.
In remoter parts of the country, where healthcare access can be challenging in rural areas, the temptation to self-medicate becomes understandable. Travelling to a clinic may require significant time and expense. But the short-term convenience carries long-term costs—both for the individual and the community.
The solution requires changes at multiple levels. Pharmacists need to enforce prescription requirements rather than selling antimicrobials freely. Healthcare systems must improve access to proper diagnosis and treatment. And individuals need to recognise that some inconveniences are worth accepting.
If you’re unwell enough to consider antimicrobials, you’re unwell enough to warrant proper medical attention. Telemedicine has expanded options; in many cases, a consultation needn’t require physical travel to a clinic. But professional assessment remains essential.
For medication already prescribed, follow instructions precisely. Take the full course at the specified intervals, even when symptoms resolve. Don’t save leftover antibiotics for future use—if medication remains after completing the course, disposal through proper channels (many pharmacies accept returns) is preferable to storage.
Never share prescription medications. What worked for your symptoms may be inappropriate for someone else’s seemingly similar condition. And never use antibiotics prescribed for a previous illness to treat a new one—even if the symptoms seem identical, the causative organisms may differ.
The convenience of self-medication comes at a price we’re only beginning to calculate. The bacteria are keeping score, even if we’re not. And in this particular game, every misused antibiotic gives them another point.
(The writers is a Consultant Microbiologist & Infection Control Officer, Bethany Hospital, Shillong)
