Unscrupulous use of antibiotics has led to health-care crisis

There is a need of raising awareness on the growing antibiotic resistance. A good quality informative data is required from public and private hospitals

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In a first-of-its-kind move to tackle growing numbers of antibiotic resistant cases in the country, Indian Council of Medical Research (ICMR) has decided to launch research projects on surveillance systems for antimicrobial resistance and antibiotic use in humans and / or animal population.

ICMR had signed a memorandum of understanding with the Research Council of Norway (RCN) in 2014 and has now called for proposals.

Across the globe, indiscriminate use of antibiotics has increasingly leaded to resistance against medicines, persistent infections and treatment failure. Antibiotic resistance has been recognised as one of the biggest public health issues in India because of which many health experts have welcomed this move by the ICMR.

Dr Om Shrivastav, Consultant Infectious Disease and Immunology, said, “This is important as antimicrobial resistance is only growing year after year. Going in for newer options to treat patients’ bacterial infection is crucial. The total structure of newer antibiotics is probably going to be critical for treating patients who get infections. We need a brand new strategy to try and combat antimicrobial resistance. That’s why this research is crucial.”

The unscrupulous use of antibiotics in the 10 years has led to a serious healthcare crisis across the country. According to experts, treating gram negative infections, which mostly affect hospitalised patients, is getting difficult because the category of bacteria is evolving and becoming even more immune to existing antibiotics.

Antibiotics

On clinical practice guidelines in hospitals, primary care and veterinary medicine Shrivastav said, “Lot of cattle’s are given antibiotics to increase weight. That may be useful in certain situations but not always. When you consume animal meat or dairy products you are actually taking all the genes of that animal. All those resistance getting transfer to you with its genes, hence guidelines are definitely a requirement for veterinary medicines.”

Talking about the misuse of antibiotics in medical sector, Dr Khusrav Bajan, Critical Care Consultant at PD Hinduja Hospital emphasised the need to have more data and research in this sector to know type of bacteria’s are causing infections.

“There also needs to have awareness on growing antibiotic resistance. A good quality informative data is required from public and private hospitals,” said Bajan.

As per the World Health Organisation (WHO), antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. New resistance mechanisms are emerging and spreading globally, threatening the ability to treat common infectious diseases, resulting in prolonged illness, disability and death. It also says that it requires action across all government sectors and society.

“It is an absolute necessary to have research projects on surveillance systems for antimicrobial resistance and antibiotic use in humans and/or animal population. We have been ignoring the growing antibiotic resistance in animal population although it has direct relation with human beings,” said Dr Jayanthi Shashtri, Dr Jayanthi Shastri who heads the microbiology laboratory of the BMC Kasturba Hospital.

Doctors said AMR requires very strong surveillance at both a micro level and macro level. “Every clinician is required to keep a track of the micro-organisms prevalent in his practice and their resistance profiles. Time, money and personnel must be invested in this surveillance on a daily basis. Clinicians and hospitals must invest heavily in cultures and convince the patient and/or the care giver regarding the importance of doing one. Hospitals must have a strong Infection Control team lead by an Infectious Diseases Specialist and must try to formulate and adhere to an antibiotic policy formulated by them. Multiple consultants with multiple choices for same aliment complicate the matter and this is a big challenge,” said Dr Mandar Kubal, infectious disease expert at Infectious Diseases & Pulmonary Care, Chembur.

He said surveillance of veterinary practices and pharmaceutical quality also is a part of AMR prevention and should not be neglected. “Coordination with appropriate authorities is most important,” he said.

Under this research the following areas are going to be covered:

  • Surveillance systems for antimicrobial resistance and antibiotic use in humans and animal populatio
  • Design, implementation and evaluation of antibiotic stewardship programs including intervention studies to promote infection control and clinical practice guidelines in hospitals, primary care and veterinary medicine.
  • Novel strategies for diagnosis and treatment of infections caused by multidrug resistance bacteria
  • Ecological, evolutionary and molecular properties of antimicrobial resistance