Got a seasonal cough we go to a pharmacy and ask for Azithromycin. Got a minor fever, cold or even headache, antibiotics have become the first choice medicine in Nepal. We take one or two pills and as soon as the symptom decreases we stop taking the pills. No one cares about the dose, or for what purpose antibiotics are used, neither the pharmacist nor the patient.

Taking antibiotics has become like eating a chocolate in Nepal. Just go to a pharmacy pay Rs.10/15 and the shopkeeper gives you a pill and then you take it. I am using the word shopkeeper instead of pharmacist because they really don’t care if it is over the counter medicine or the prescriptive! Most of them even don’t feel it necessary to tell the right dose to the patients. The shopkeeper gets his profit and the patient his medicine. Both the parties are pleased. Why should they care about the consequences-- antibiotic resistance?

Out of thousands of pharmacies in Nepal, only a few hundreds are currently run by pharmacists or assistant pharmacists. The remaining is run by “aushadibyabashi”. This means the majority of our pharmacies are in the hands of someone who is completely profit oriented and knows very little (only names and some uses) of some medicines. Antibiotics are expensive and offer greater profit margins. So, why wouldn’t the shopkeeper sell that medicine to anyone who comes asking for it? Why would he bother asking for prescriptions or telling about the consequences?

Similarly, companies offer an attractive and mouthwatering commission to the doctors to prescribe antibiotics. The more you prescribe the higher is your commission. Therefore, even higher dose antibiotics and also the reserved group antibiotics are found being randomly prescribed. We can see at least an antibiotic in every single prescription today. All the antibiotics that that we currently have are already exposed and bacteria have developed resistance against most of them. Hospital acquired pneumonia has become very common. It is a situation where a patient is infected by antibiotic resistance species of bacteria and he/she has to die because of this infection rather than the disease they originally had.

Thus, this random practicing, prescribing and selling of antibiotics has led us to a catastrophic antibiotic resistance situation. A significant number of premature deaths occur every day in hospitals due to poor conditions of hospitals.