After all the dust that last year's Lancet article on the drug-resistant NDM-1 strain kicked up, the World Health Organisation has decided that there has been sufficient provocation to urge for a global movement to safeguard antibiotics for future generations.

The movement, that kicked off from World Health Day, 2011, targets the growing resistance by microbes to antibiotics thus threatening the effectiveness of several drugs. Appropriately, the theme this World Health Day, which was commemorated recently, was ‘Antimicrobial resistance: no action today, no cure tomorrow.'

Time for sustained action

WHO's regional director, South-East Asia Samlee Plianbangchang, said in his message , “The time for sustained action is now, since we are slowly but surely moving towards a reversion to the dreadful pre-antibiotic era. If that happens, death and disease due to untreatable infectious diseases will become the biggest obstacle to poverty alleviation, development.”

The WHO is now urging governments and stakeholders to implement policies and practices to prevent and counter the emergence of highly resistant micro organisms.

S. Elango, Tamil Nadu president of the Indian Public Health Association, says, “We live in an era that is dependent on antibiotics. While resistance is not a new problem, it is increasing at an alarming rate. The emergence of new infections and re-emerging old infectious and communicable diseases is very bad news indeed.” Multi-drug resistance causes the standard treatment to become ineffective, and drugs become more expensive, sometimes superseding the purchasing power of the people.

Thara Francis, senior consultant microbiologist, Frontier Lifeline Hospital, says a key reason for the increasing resistance is the overuse of antibiotics – either self administered by the patient, or over prescribed by the doctor. “Not every fever and sore throat requires antibiotics, but patients think, mistakenly, that they will get better only with antibiotics. When unnecessary drugs are taken, the body develops resistance.”

“What people must realise is that every fever is not because of an infection, and does not require an antibiotic. General practitioners must also be aware of the fact. It is harmful to rely on antibiotics to cover up any lapses in infection control or treatment,” Dr. Francis adds.

For instance, most upper respiratory infections do not warrant antibiotics, as they are mostly viral infections. Antibiotics have no effect on viral infections.

A key issue she highlights is the indiscriminate use of surgical antibiotic prophylaxis. A single dose is given, at least 24 hours before surgery, except in some instances.

However, most hospitals in the private and public sector easily use the drug for seven to 10 days post surgery, she chargesPrincipal Secretary, Health, V.K.Subburaj, says the only way ahead is the “educate our people on the rational use of antibiotics.” Medical professionals too must be cautioned to prescribe rationally, he says. Such messages would also have to be disseminated on a continuous basis. While at a larger level, he acknowledges the need for a policy to regulate the use of drugs, specially antibiotics, Mr. Subburaj says the process is fraught with difficulties.

Keywords: antibiotics