Antibiotics aren’t Tic-Tacs: The dangers of casual consumption

Rampant use of antibiotics has led to many bacteria developing antibiotic resistance


During the height of the Omicron wave in 2022, a friend developed a cough and called for advice. While I was trying to find out if he had other symptoms or signs of Covid-19, he told me happily that he had already started a popular antibiotic brand (a combination of amoxicillin and clavulanic acid) on the advice of another non-doctor friend, who had memorised the prescription that a third doctor had given during the earlier Delta wave.

His friend was confident that this antibiotic would make him better. My friend’s cough disappeared in two days which likely would have happened anyway, but he ascribed it to the use of the antibiotic, which he then stopped immediately at the end of the third day, without bothering to finish the standard five-day course.

The troubling part is that the next time he has a cough, cold and fever, he will again pop a few of these antibiotic tablets and encourage others around him to do the same. Though this particular combination is a prescription drug, it is easily available over the counter in most pharmacies in India without a prescription.

In 2022, the Lancet published an analysis of worldwide antimicrobial resistance [1] by the Antimicrobial Resistance Collaborators. They attributed 1.27 million (12.7 lakh) deaths worldwide in 2019 directly to antibiotic resistance, while in a total of 4.95 million (49.5 lakh) deaths, antibiotic resistance played a significant role.

The rampant use of antibiotics has led to many common bacteria developing antibiotic resistance. My mom had a bad pneumonia some time ago and her sputum culture showed that the bug (Streptococcus) was resistant to at least 3 common antibiotics, including the one she had been taking till then. Luckily, the bacterium was sensitive to other common antibiotics such as penicillin and she recovered quickly after the antibiotic was changed.

During the first and second waves of Covid-19, antibiotics such as azithromycin were prescribed as frequently as paracetamol. Self-medication with antibiotics, as with my friend then adds another layer to the whole problem.

Most fevers of short duration are viral in etiology. Antibiotics have no role in viral fevers, except in some situations such as in immunocompromised patients, where the treating doctor may believe it is necessary to give antibiotics prophylactically. To pop antibiotic pills as if they were Tic-Tacs, whenever you feel like taking one, without any logic or sense, just adds to the unfolding crisis of increasing resistance to antibiotics and consequent increasing morbidity and mortality. Antibiotics also need to be taken for a specific duration of time, usually not less than 5 days, to ensure they get enough time to do their work of killing the bad bacteria, without leaving some half-treated ones behind, which could then mutate and become resistant.

In South Asia alone, the Antimicrobial Resistance Collaborators estimate around 389,000 deaths in 2019 directly due to antibiotic resistance and 1.39 (13.9 lakh) million deaths partly due to antibiotic resistance. These are big numbers and most likely an underestimate, as with all such data from India.

Antibiotics have their side effects. Apart from nausea and diarrhoea, they kill the normal bacteria and flora that make up our gut microbiome, which in turn is intimately associated with our mental well-being, our appetite, weight loss/gain and other health parameters. Like with everything in life, there is no free lunch. And you don’t really want to mess with your gut microbiome unnecessarily.

What does this mean for you and I? In my first piece in this column in March 2024, I had written, "the real reason for increased longevity is socio-economic and political; reduction in poverty, better education, clean water, better sanitation, adequate nutrition, immunization and the use of antibiotics.”

Antibiotics save lives. Period. They reduce the morbidity and mortality associated with bacterial infections. But they have to be used judiciously.

So, please, please…don’t take antibiotics on your own, without a definite proven infection and a doctor’s prescription.

Question your doctor if you are prescribed antibiotics each time you have a viral fever or some cough or feel under the weather. Just as you do extensive online and offline research and think ten times before booking a vacation, so also with antibiotics…think ten times and then some more, before putting them in your body.

Just as moving regularly, eating sensibly, sleeping well and not falling are important in our quest towards a long healthspan, our behaviour when it comes to medications and similar health-related issues, is also important.

You don’t want to be that person who lands up with a bacterial infection that no antibiotic works on because all the bacteria infecting you have developed antibiotic resistance, perhaps because you were the one popping antibiotics like antacids and painkillers.


1. Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022 Feb 12;399(10325):629-655.

Dr. Bhavin Jankharia’s new book 'Atmasvasth' available online, dives deeper into this concept. He can provide references for all statements of fact and can be reached at