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Comment by rm2889 | Hacker News Reader

I live in India and despite some improvements, the level of antibiotic abuse here is shocking. They're available over the counter and people self-medicate with antibiotics all the time. The attitude is, "if my sore throat doesn't go away in a couple of days, its time to take antibiotics. No point in going to the doc coz they'll prescribe antibiotics too and this way I save money."

People self-medicating on antibiotics end up taking an incomplete dose without fully understanding the implications. This has lead to the rise of superbugs like https://en.wikipedia.org/wiki/New_Delhi_metallo-beta-lactama...

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This is pretty fucking terrifying. A bacterial 'petri dish' of over a billion humans.

India is actually the free world's final exam. Biggest democracy in the world, a population that will soon surpass China, yet it is poor, uneducated, the government is highly dysfunctional.

Every year that we fail to help India reach the superpower status hints at chinese-style authoritarianism being a superior model. I wish we would spend more time and effort helping them.

A democracy while casts are still very much alive ? Democracy means nothing in India.

I'd imagine it's not much different in Central and South America based on my travels. You can walk into any pharmacy and show them the word "amoxicillin" and they'll give you a 2 week course.

Edit: a word

Can confirm South America.

It used to be like that in Brazil, but in recent years Anvisa (the Brazilian equivalent of the FDA) tightened policy on this and now people can only buy antibiotics with a prescription.

BTW, in my experience Brazilian doctors prescribe antibiotics a lot less than American doctors.

Even the EU is bad - Spain and Portugal allow OTC antibiotics (along with many Asian countries)

Central America here, can confirm.

That's bad, but at least it's a two week course. Often people in India will buy a few days because that's all they can afford.

So this is the way it works in India. Most people who know a little english remember the brand name of the drug.

Others just walk to the pharmacy store and narrate the symptoms to the pharmacist. Typically: Sore throat, a little fever etc. Then they state their budget(10-20 rupees), the pharmacist gives two tablets of Azithromycin.

A country that allows humans to buy antibiotics over the counter OR allows antibiotic use in healthy livestock needs to be heavily sanctioned very quickly. Sanctions from the international community can include ceasing aid, adding visa requirements or other travel restrictions, food import bans, or whatever.

I don't understand why other countries (and the international community as a whole) still accept this behavior.

"Approximately 80 percent of the antibiotics sold in the United States are used in meat and poultry production.2 The vast majority is used on healthy animals to promote growth, or prevent disease in crowded or unsanitary conditions."

https://consumersunion.org/news/the-overuse-of-antibiotics-i...

Exactly. It happens almost everywhere. I claim moral superiority coming from a place where there are no over-the-counter antibiotics and none used in healthy livestock :)

We spend so many billions in subsidies to farmers, I wonder why we can't push them to adopt better growing and animal husbandry practices.

Its actually more worse.

Its like "I seem to have sore throat, let me take this anti-biotic right now, so that it doesn't escalate to something big later"

And they are right too. Most doctors write down the same regimen of antibiotics every single time.

Either way most doctors in India care about nothing apart from money and their immediate interests. Many realize they will never do a MD, so there are a lot of small time clinics, with rudimentary testing labs for blood work. They only care about maximizing per visit consultation fees and commission they get from the pharmacy store next door.

Its a huge mess, and there are no ways to fix it given the population scale.

This happens in Moldova too.

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