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Updated: October 26, 2012 16:54 IST
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Wanted: a policy on antibiotics

R. Sujatha
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What will happen if antibiotics fail? Rampant misuse of antibiotics has resulted in patients developing resistance to several drugs.
What will happen if antibiotics fail? Rampant misuse of antibiotics has resulted in patients developing resistance to several drugs.

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.

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Symposium on antibiotic resistance August 16, 2012

antibiotic policy is an important aproach towards the prevention of antibiotic
resistence.since the antibiotic reaistence is a serious probi
lem hence it needs to be watched closely. it is not the concern of a singal nation but
is a global problem.so the main objective of the policy should be to closely moniter
the resistence development.if this problem left unchecked the time is not far when
we left with no antibiotic to treat a disease like in pre flammings ara.

from:  Niyaz ali
Posted on: Aug 18, 2012 at 12:05 IST

Just to clarify a common misconception - it is not the patient who 'develops resistance' to antibiotics, but the germs - here, bacteria - that develop resistance, by being able to neutralise the antibiotic when a low or insufficient dose is used.

from:  Krishnan
Posted on: Aug 18, 2012 at 06:32 IST

A lot of diseases are caused by bacteria and cleanliness is a major factor in countries like India.In this context i want to commend Bill gates's initiative to invent a cheap and efficient lavatory for masses.

from:  kirubakaran
Posted on: Aug 18, 2012 at 00:30 IST

It is eye opening article. I think it is time to make antiboitic policy
as resistance bacterial has started to evolved in people so government
should not sit idle and watch antibiotic crisis in our nation. Just
think if antibiotic resistance bacteria rampant in even on in a few
number of people then it would be worst situation to handle. I would
like to give my opinion Stop waiting for that worst to happen and pass
that policy.
Thank you.

from:  Latika
Posted on: Aug 17, 2012 at 11:20 IST

This will be Herculean task. The public are used to being dished out antibiotics willy nilly by a
lot of the clinicians but equally any Tom Dick or Harry can go to a chemist and get most
antibiotics over the counter.

It needs a culture change from not just the prescribers and pharmacists but also those in the
public who think it is the cure for all their illnesses.

from:  K Sivarajan
Posted on: Aug 17, 2012 at 01:04 IST

Ay eye opening article!! Our country hardly follows strict infection
control protocols including public and many private care providers.
First we need mandatory infection control training program for each and
every staff member involved in heath care delivery. Timely isolation is
also key to prevent infection in hospital setting. We hope india will
overcome issue by strict mandatory policy from the beginning.

from:  Dr Biren
Posted on: Aug 16, 2012 at 22:03 IST

Indiscriminate use of Antibiotics for minor self limiting disease is a curse. In the Western countries, one will not be able to get an antibiotic without a doctor's prescription. In India any one can buy it from pharmacies. Patients as well as many doctors believe an antibiotic can cure diseases. Even when they come to the UK, some doctors firmly believe in prescribing antibiotics for common cold and cough.

Until corrupt practices are eliminated and the pharmacists who dispense prescription only medicines without authorisation are punished, I am afraid India will be a place where antibiotic resistance is actively encouraged.

You can have any number of meetings with any related professionals. I feel there is no need to re-invent the wheel. Follow the time tested good practices from the western world and implemenr them. Problem solved.

from:  Chandran
Posted on: Aug 16, 2012 at 21:53 IST

The need of the hour is certainly the formulation of
effective,implementable,practicable policy on antibiotic usage. The
situation in India where majority succumb to infectious diseases makes
it even more important to have policy at the earliest.

from:  shashikiran j
Posted on: Aug 16, 2012 at 16:19 IST

Antibiotics misuse and disuse create new diseases.Antibiotic resistance is emerging as a serious health care issue.Under counter sale of prescriptive drug like antibiotics are so rampant that self medication without assistance from Doctors is killing slowly the affected.The medical shop owner or unlicenced attendant prescribes antibiotics to the innocent patient.Costs are also prohibitive as well.Administering antibiotics to birds and cattles and getting into human system is again a matter of concern.Natural human friendly microorganisms are also eliminated and get deposited in kidneys leading to organ dysfunction.It is high time the Government intervene and take stringent measures against the greedy and anti socials.Exemplary punishment should be awarded.You cannot get prescription drugs without notes from the concerned doctor.Side effects are also to be explained to patients by the dispensary attendant.

from:  Dr K V Peter
Posted on: Aug 16, 2012 at 15:33 IST
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