Your doctor must have prescribed you antibiotics many times. Sometimes these medicines stop working and the doctor tries to figure out why–and from there, create a new plan of attack. In some cases, medicines stop working if you become resistant to them and this condition is known as Antimicrobial Resistance (AMR).
Antimicrobial resistance (AMR) has been a problem since the discovery of penicillin, and will continue to be a problem as long as there are infections that require treatment.
According to the World Health Organization (WHO), AMR is a global issue that results in 4.95 million deaths per year.
Dr. Tushar Tayal, Consultant, Internal Medicine, CK Birla Hospital, Gurugram told Financial Express.com that when medicines stop working, it typically means the body is no longer responding to the treatment as expected.
This can happen for several reasons, depending on the condition being treated and the type of medicine. According to Dr. Tayal, there can be several causes for this:
- Drug Resistance: The disease-causing organisms (like viruses, bacteria, or cancer cells) adapt to the medication, making it less effective. In such cases, switching to a different combination of drugs with a different mechanism of action might be more effective
- Poor Adherence: Missing doses or not following the prescribed schedule allows the condition to progress or develop resistance. Simplifying treatment regimens or using reminders to improve compliance is necessary
- Drug Tolerance: Over time, the body can build a tolerance to certain medications, reducing their effectiveness (common with painkillers or sedatives).
- Progression of Disease: The underlying condition may worsen, making the current treatment insufficient. In such cases the treatment plan should be reassessed and more advanced therapies or clinical trials should be explored
- Drug Interactions or Side Effects: Other medications, supplements, or foods may interfere with the drug’s action, making it less effective. Side effects might lead to discontinuation of treatment. In such cases alternative medications may be considered.
Meanwhile, Dr Shobha Subramanian Itolikar, Consultant-Internal Medicine, Fortis Hospital Mulund revealed that medicines can stop working and not give desired results due to a number of reasons like:
- Incorrect diagnosis: Medications will be ineffective because the underlying issue will not be properly treated.
- Interaction with meals: Some drugs have to be taken in fasting state as they cannot be absorbed in the presence of food in the gut
- Development of tolerance i.e. dosage might fall short after some time due to saturation of receptors at cellular levels, thus patient may need dosage adjustment for medicine to work
- Development of resistance: In case of antibiotics the individual might develop resistance to the drugs
- Existence of burnout conditions, such as diabetes, where an incorrect medication choice may lead to inefficacy
She also said that besides these reasons, improper dosage amount, inadequate duration of medication, wrong timing of administration, interaction with other medications or alcohol, and consuming expired medicines can render medicines ineffective.
Other extraneous factors such as insufficient sleep, could be exacerbating the underlying pathophysiology instead of improving it, as seen in conditions like diabetes mellitus and dyslipidemia, this too can make medicines ineffective, she said.
“When your medicines stop working the desired disease response is not obtained. For example, if you are on medication for high blood sugar, blood pressure, cholesterol etc., these chronic conditions will remain uncontrolled. Additionally, complications arising out of uncontrolled disease might set-in,” Dr. Itolikar told Financial Express.com.