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Sansad TV: Perspective- Drug-Resistant Microbes

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Introduction:

The Indian Council of Medical Research has found in its research that disease-causing microbes are increasingly becoming resistant to antibiotics due to the rampant use of drugs. This can prove to be very dangerous in the future as diseases caused by drug-resistant microbes will become very difficult for doctors to treat. The ICMR study found that large proportions of patients are now resistant to carbapenem — a powerful antibiotic to treat pneumonia and septicemia as they have developed what is called antimicrobial resistance in medical parlance. The data collected from the network has enabled compilation of drug resistance data on six pathogenic groups on antimicrobial resistance from the country.

Antibiotics:

  • An antibiotic is a type of antimicrobial substance active against bacteria and is the most important type of antibacterial agent for fighting bacterial infections.
  • Antibiotic medications are widely used in the treatment and prevention of such infections.
  • They may either kill or inhibit the growth of bacteria.
  • Antibiotics are not effective against viruses such as the common cold or influenza; drugs which inhibit viruses are termed antiviral drugs or antivirals rather than antibiotics.
  • Antibiotics are medicine used to treat infections caused by bacteria. Antibiotic Resistance refers to resistance developed by bacteria against antibiotics or the ability of bacteria to mutate or change so as to resist the effects of antibiotics. The more we use them, and the more we abuse them, the less effective they become.
  • Thanks to that annoying thing called evolution, bacteria are constantly adapting to counter-attack antibiotics. Antibiotic resistance is one of the most significant threats to patients’ safety. It is driven by overusing antibiotics and prescribing them inappropriately.

Key findings:

  • India is one of the top users of antibiotics.
  • The private sector clocked high levels of antibiotic prescription rates (412 per 1,000 persons per year).
  • The highest rate was seen among children aged 0–4 years (636 per 1,000 persons) and the lowest in the age group 10–19 years (280 per 1,000 persons).
  • Per-capita antibiotic consumption in the retail sector has increased by around 22% in five years from 2012 to 2016.

Concerns:

  • Antibiotic resistance is already one of the biggest health risks and is estimated to kill 50 million by 2050 worldwide.
  • The threat continues to escalate globally because more than 50 per cent of antibiotics in many countries are used inappropriately such as for treatment of viruses when they only treat bacterial infections or use of the wrong (broader spectrum) antibiotic.
  • Besides, reduced access to effective and appropriate antibiotics in many low- and middle-income countries contributes to childhood deaths and lack of funding and implementation of national plans to tackle antimicrobial resistance.

Way forward:

  • Poultry:
    • Ban the use of antibiotics for growth promotion and mass disease prevention. It should only be used to cure the sick animals based on prescription of veterinarians
  • Rationalizing antibiotic use to limit antibiotic resistance in India.
  • Improving regulation of drug production and sale
  • Encouraging behavior change among doctors and patients are of immediate priority.
  • Regulation of the medical sector, particularly in the prescription of medicines.
  • Improved management of the health care delivery systems, both public and private, will minimize conditions favourable for the development of drug resistance.
  • Improved awareness of antimicrobial resistance through effective communication.
  • Reducing the incidence of infection through effective infection prevention and control. As stated by WHO, making infection prevention and hand hygiene a national policy priority.
  • Discourage non-therapeutic use of antimicrobial agents in veterinary, agriculture and fishery practices as growth-promoting agents.
  • Promoting investments for antimicrobial resistance activities, research and innovations
  • Strengthening India’s commitment and collaborations on antimicrobial resistance at international, national and sub-national levels.
  • Regulate the release of antibiotic waste from pharmaceutical production facilities and monitoring antibiotic residues in wastewater.