ICMR advises against indiscriminate antibiotic use amid rising cases linked to Influenza subtype A H3N2

The H3N2, which has been in wide circulation for the past two-three months, causes more hospitalisations than other subtypes, said Indian Council of Medical Research (ICMR) scientists who keep a close watch on ailments caused by respiratory viruses through the Virus Research and Diagnostic Laboratories network.

Also Read:DAK demands free swine flu vaccine for high risk groups in Kashmir

Dr Arjun Dang, CEO, Dr Dangs Lab, observed that there are a lot of H3N2 Influenza cases being reported in comparison to H1N1. This virus causes more hospitalization and respiratory issues than its other subtypes. 

Some of the common symptoms of H3N2 virus are fever, respiratory symptoms like cough and runny nose, body aches, nausea, vomiting, or diarrhoea. The ICMR has 30 Viral Research and Diagnostic Laboratories (VRDL) for respiratory virus surveillance, which are attached to the top medical colleges in different states and collect information of those suffering from severe acute respiratory infections (SARI). 

The ICMR reported that around half the patients admitted with SARI have Influenza A H3N2. Out of them, 92% had fever and 86% had cough. Further, 27% got breathlessness, 16% showed wheezing symptoms, 16% had signs of pneumonia and 6% suffered from seizures. The body stated that 10% of all SARI patients who have Influenza A H3N2 required oxygen and 7% required ICU care. 

ICMR also issued a number of guidelines, with the foremost advice being avoiding antibiotics. Some of the symptoms include fever, cough, loss of voice, and shortness of breath, with the most common symptom being uncontrollable cough, with or without wheezing. 

The ICMR has recommended avoiding crowded places, practising good hand and respiratory hygiene, getting annual flu shots, controlling indoor air quality, wearing a pollution mask when outdoors, and avoiding home remedies without consulting a doctor. Further, it also advised people to stop taking antibiotics once they feel better as it leads to resistance. It observed that several other antibiotics are being misused for certain conditions and are developing resistance among patients, reports India TV. 

The Indian Medical Association (IMA), on the other hand, has advised against indiscriminate use of antibiotics amid rising cases of cough, cold and nausea across the country, giving cautionary advice against the H3N2 virus. Seasonal fever will last five to seven days, it said.

The fever goes away at the end of three days but the cough can persist for up to three weeks, the IMA’s Standing Committee for Anti-Microbial Resistance said. The IMA, as per a media report in the Live Mint, said, "Right now, people start taking antibiotics like Azithromycin and Amoxiclav, etc, that too without caring for done and frequency and stop it once start feeling better. This needs to be stopped as it leads to antibiotic resistance. Whenever there will be a real use of antibiotics, they will not work due to the resistance." 

Viral cases have also surged due to air pollution, it said, adding that it mostly occurs in people aged below 15 and above 50 and causes upper respiratory infections along with fever. The association also asked doctors to prescribe only symptomatic treatment and not antibiotics.

“Right now, people start taking antibiotics like Azithromycin and Amoxiclav, etc, that too without caring for frequency and stop it once start feeling better. This needs to be stopped as it leads to antibiotic resistance. Whenever there will be a real use of antibiotics, they will not work due to the resistance,” the IMA said in a statement.

The most misused antibiotics are Amoxicillin, Norfloxacin, Oprofloxacin, Ofloxacin and Levofloxacin. These are being used for the treatment of diarrhoea and UTI, it said.

“We have already seen widespread use of Azithromycin and Ivermectin during Covid and this too has led to resistance. It is necessary to diagnose whether the infection is bacterial or not before prescribing antibiotics,” it said.

However, Oseltamivir, zanamivir, peramivir, and baloxavir could be used to treat those suffering from the H3N2 virus, with advice from the physician. Further, it is important to get annual flu vaccination prevent such severe respiratory infections. 

Speaking to the Hindu, Mumbai-based senior physician Altaf Patel said, "The cases have certainly risen, and patients are presenting with breathlessness and severe episodes of spasmodic cough. Some patients are showing symptoms for as long as 10 to 12 days." Patel stated that the symptomatic differences between COVID-19 and the illness brought on by Influenza A H3N2 are very few. 

Dr Patel added, "Wearing masks while venturing out is a good idea. It is important for people to take their flu vaccination." 

Also Read:Influenza vaccination increases risk of Guillain-Barre syndrome within one month