The Indian Medical Association (IMA) has warned against self-medicating with antibiotics amid a surge in H1N1 cases, saying the misuse of drugs such as azithromycin and cefixime can fuel antimicrobial resistance. The doctors' body also said there is no evidence of a new genetic mutation in the virus currently circulating in India.

The warning comes as Delhi has reported more than 1,770 laboratory-confirmed H1N1 cases, with infections also being reported from Maharashtra, Karnataka and West Bengal.

"Influenza A (H1N1) is a viral illness - Antibiotics do not kill viruses," the IMA said in its public health advisory issued on August 26.

The IMA said people should not take antibiotics including azithromycin, amoxicillin-clavulanate and cefixime for flu symptoms unless a doctor diagnoses a secondary bacterial infection.

"Indiscriminate antibiotic use during viral surges destroys protective microbiome flora and fuels lethal Antimicrobial Resistance (AMR)," the advisory said.

The association also cautioned against taking oseltamivir, an antiviral drug, without medical supervision. It said the drug is prescription-only and should be reserved for specific clinical categories.

No new H1N1 mutation detected

While cases are rising during the monsoon, the IMA said there is no indication that a new strain of the virus is driving the increase.

"Surveillance by the Indian Council of Medical Research (ICMR) confirms that the circulating virus remains seasonal influenza A (H1N1) without any novel genetic mutations," the advisory said.

The IMA said most H1N1 infections are mild and self-limiting and stressed that there is "no cause for panic", while calling for heightened vigilance.

Symptoms and warning signs

H1N1 typically causes a sudden onset of high-grade fever and chills, persistent dry cough, sore throat, muscle aches and fatigue. Headache, a runny or congested nose, nausea, vomiting and loose stools may also occur, particularly in children.

The IMA has advised immediate hospital care if patients develop difficulty breathing, shortness of breath or rapid breathing; chest pain or persistent pressure; bluish lips or fingers; blood in sputum; confusion, extreme drowsiness, or seizures.

Persistent vomiting and an inability to tolerate fluids are also red flags. In children, inability to feed, lethargy, grunting or severe chest retractions require urgent medical attention.

Also Read: Antivirals, Not Antibiotics, Work For H1N1: How Oseltamivir Treats Influenza Viruses

IMA warning on antibiotics

The IMA's advisory has put particular focus on the misuse of antibiotics during the current flu season.

"H1N1 is a viral illness - Antibiotics do not kill viruses," the medical body said, advising people not to take azithromycin, amoxicillin-clavulanate, cefixime, or other antibiotics for flu symptoms.

The IMA warned that indiscriminate antibiotic use during viral surges can destroy protective microbiome flora and "fuel lethal Antimicrobial Resistance (AMR)."

Antibiotics, it said, should be used only when a qualified physician diagnoses a secondary bacterial infection based on clinical and laboratory findings.

The advisory also cautioned against self-medication with oseltamivir, an antiviral used in the treatment of influenza.

"Do not self-administer antivirals," the IMA said, stressing that oseltamivir is a prescription-only medicine and should be used for specific clinical categories under medical supervision.

IMA's advice to prevent spread

The IMA has advised frequent handwashing, covering the mouth and nose while coughing or sneezing, and wearing a well-fitted mask in crowded or enclosed spaces.

People who are sick should avoid schools, workplaces, and social gatherings for at least 24 hours after their fever has resolved without the use of fever-reducing medication.

Annual seasonal influenza vaccination has been strongly advised for healthcare workers, pregnant women, the elderly, and people with underlying chronic medical conditions.

Read More: H1N1 Surge Is Seasonal, No New Strain, No Cause For Panic: ICMR Clarifies



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