It needed a scare like NDM-1 for the country to wake up to a policy to regulate antibiotics. But after announcing with much fanfare that a policy would be in place, the government withdrew the decision. We have arrived at a crossroads and there is no solution to the crisis yet. Organisations comprising medical practitioners across the country will come together in Chennai on August 24 to discuss the possibility of evolving a road map that will help the government prepare and implement an antibiotic policy. Physicians, surgeons, gynaecologists, oncologists and representatives from the World Health Organisation and Medical Council of India will deliberate on the need to evolve an antibiotics policy.
The approach to treating diseases changed after Alexander Fleming’s accidental discovery of penicillin. It was this discovery that saved hundreds of wounded soldiers during World War II. What began in the 1940s turned into a flurry of activity, leading to manufacture of a large number of antibiotics. But soon, everything changed. Today the number of antibiotics manufactured across the world has fallen drastically and adding to the woes is the fact that its unchecked use has resulted in bacteria developing resistance to several antibiotics.
Across the world, every country has been battling the antibiotic resistance war. Antibiotic resistance would mean that 2.5 million deaths would occur due to infections. Simply put, resistance would mean no more drugs and back to the pre-Fleming days. While other nations have formulated a policy, India has done nothing, says Abdul Gafur, Indian coordinator of World Alliance Against Resistance, who will also coordinate the roadmap meeting in the city.
What will happen if antibiotics fail? Usually, a doctor would prescribe alternatives to an antibiotic if the patient is found resistant to one set of antibiotics. But rampant misuse of antibiotics has resulted in patients developing resistance to several antibiotics, Dr. Gafur says. The problem is compounded in countries where animals have been fed antibiotics and eating the cultivated meat has passed on resistant strains of the bacteria to humans.
Some large hospitals in the country follow a routine of culturing bacteria taken from patient samples. When a patient exhibits resistance to a set of antibiotics, she/he is isolated and an infection control protocol to prevent the next patient from acquiring resistance is followed. This protocol should be made mandatory for all hospitals seeking accreditation from the National Accreditation Board for Hospitals, Dr. Gafur says.
While doctors and smaller hospitals and clinics should follow simple prevention steps such as washing hands between examining patients, wearing gloves and apron while treating a patient with resistant bacteria, larger hospitals should have a vibrant infection control cell, and a policy for rational use of antibiotics. “What we are doing now is crisis management. India needs a practical antibiotics policy which can initially be liberal and later be made stringent,” Dr. Gafur says. All countries are sailing in the same boat. But while some developed countries have started evolving a policy, India is merely observing the situation. A country that has been promoting medical tourism should pay attention to the crisis, Dr. Gafur says.