One out of every five patients who walk into the outpatient departments or clinics suffers from a Fungal Infection, of which, 50 per cent of patients are becoming resistant to treatment despite being treated for over six months. City doctors have noticed a sharp rise in skin infections caused by stubborn fungi, which need a more aggressive and longer course of treatment.
While the city’s humidity and construction activity makes it easier for the fungi to thrive and spread, doctors say the use of over-the-counter creams and ointments that often contain steroids have contributed to a spurt in the infections as well as resistance to them.
A senior doctor said due to humidity people are getting drenched in sweat which has given rise to skin infections. Moreover, the primary reasons observed for the increase in the incidence of chronic resistant fungal infections are non-compliance to medication, over or under-dosing, self-medication and rampant adoption of ‘one-stop-solution’ medications.
“For the last two weeks, 25-30 per cent of patients are taking treatment for a skin infection on an OPD basis. Meanwhile, more than 1,000 patients are complaining of skin infections every day in the OPD of the King Edward Memorial (KEM), Sir Jamshedji Jeejeebhoy (JJ), BYL Nair and Lokmanya Tilak Municipal General (Sion) hospitals,” said doctors.
Senior dermatologists from the civic-run hospitals said they see 50 to 75 cases of fungal infections every day in the outpatient department (OPD). “Patients typically spend a lot of time trying to treat symptoms with over-the-counter combination creams. Another major problem is an interruption in treatment. Patients stop treatment midway and the fungi multiply aggressively,” he said.
Fungi thrive in moist, damp areas of the body. The infection starts with skin changes that worsen with itchiness, redness, etc. Doctors say the infection is commonly seen in the underarm and groin regions, buttocks, inner thighs, and so on. “People self-medicate and mostly use steroid-based creams. While they get temporary symptomatic relief, the fungi’s growth continues. By the time they reach us, the infection is extremely stubborn,” said a doctor from the skin department of J.J. Hospital. Of the daily OPD of 350 patients, nearly 80% come with fungal infections, he said.
Dr Rahul Tambe, Senior Consultant, Internal Medicine at Nanavati Super Speciality Hospital, Vile Parle said the major causes of widespread fungal infections are humidity, followed by hygiene and environmental factors and most importantly, irresponsible and unprescribed use of antifungal medication said
Dermatologists at the private-run hospitals said they are seeing 6-8 patients a month complaining about resistant fungal infections in blood or urine, while the dermatologists are seeing 5-6 such patients daily with skin-related fungal infections. Nearly 20-25 per cent of patients in Intensive Care Units (ICU) are diagnosed with such invasive fungal infections.
“Abuse of anti-fungal medication through unprescribed Over The Counter (OTC) sale is one major cause of the fungus developing resistance against the medication. Any person on unprescribed antifungal medication who stops taking medication after initial relief and does not complete the course is bound to develop resistance against that very medication. We as a society have to carefully tread on antibiotics abuse to prevent this serious matter of antibiotics resistance,” said a doctor on condition of anonymity.
The rise in cases and resistance has also led to an increase in the sale of anti-fungal medication. “Over the past two years, the prescriptions of anti-fungal creams and medicines from general practitioners and dermatologists have doubled,” said an employee working at the chemist shop in Parel.
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