Chemists not to blame for drug-resistant TB, says study
The neighbourhood chemist, who doubles as a
standby doctor for many Indians, can't be blamed for the raging epidemic of
drug-resistant tuberculosis in the country. This endorsement comes from a
three-city study published in journal Lancet Infectious Diseases on Thursday.
The study found 622 pharmacies in the city,
Delhi and Patna doled out antibiotics and steroids with ease to dummy patients
who complained of TB-like symptoms. “Chemists
gave medicines to over 80% of simulated patients, who were sent to the
pharmacies to enact symptoms of TB such as persistent cough and fever,”
main author of the study Dr Srinath Satyanarayana told TOI. Worse, around 30%
of these patients were sold antibiotics. “Ideally
such patients should not have been given antibiotics or steroids and told to go
to a doctor. Only 13% of patients were given ideal advice,” Satyanarayana
said.
Co-author Dr Madhukar Pai, an epidemiology
specialist from McGill University in Canada, said patients were given
antibiotics despite regulations against dispensing them without prescriptions
and this could be fuelling anti-microbial resistance.
The study was undertaken to understand the
role of pharmacies in fuelling drug-resistance in community. Two sets of dummy
patients were trained and sent to 622 pharmacies in Mumbai, Delhi and Patna.
While the first set were trained to enact TB symptoms and ask for medicines,
the second set was given a diagnostic report to show they had TB. “In the
second set of patients, we found the chemists were extremely careful. For 62%
of these patients, they were very cautious once the diagnosis was there,” said
Dr Satyanarayana. The authors said their pharmacies' study provided the
backdrop for another study published in Lancet Infectious Diseases on Thursday,
which showed India's drug-sensitive TB burden was twice of what has been
estimated so far.
The other study done by India's Central TB
Division, Imperial College in London and the Bill & Melinda Gates
Foundation looked at sale of anti-TB drugs in the country to estimate India
has 2.2 million patients in the private sector alone. The total TB disease
burden in India could be almost 3.8 million, said the first study. “Our study shows as chemists don't dispense
anti-TB drug without prescription, most anti-TB drugs are given to patients
diagnosed (rightly or wrongly) as TB patients,” said the authors.
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