There was a time around the middle of the last century when it seemed that humans could decisively vanquish the microbes that caused so many dreadful, often deadly, diseases. But that sense of victory over an enemy has given way to alarm. Drug-resistant pathogens have sprung up and ‘superbugs' that can shrug off most drugs that are thrown at them have surfaced and spread across the world. With few new antimicrobials under development, there is a real sense among medical experts of humanity having its back to the wall and of the frightening possibility of a return to the bad old days when what started as a simple infection could get completely out of control. This year's World Health Day (April 7) focusses on antimicrobial resistance and its global spread. In a highly interconnected world, drug-resistant microbes can leap from one country to another. Last year, there was a furore over the spread of highly drug-resistant bacteria, which had the New Delhi metallo-beta-lactamase (NDM-1) gene, from South Asia to several countries. But ‘superbugs' have made their way to India from elsewhere in the world too. For instance, studies of methicillin-resistant Staphylococcus aureus (MRSA) bacteria isolated in India have indicated a movement of such organisms from the United States, Europe, and Australia to this country.
In India, as in other countries, such dangerous microbes are circulating not only in hospitals but also in the larger community; poor sanitation and faecal contamination of water supplies have allowed some highly antibiotic-resistant bacteria to spread. Drug-resistance is a major issue in tuberculosis. India accounts for one-fifth of the global burden of the disease and two people die of it every three minutes. The rise of resistance as a natural consequence of the process of evolution is perhaps inevitable. But the misuse of antibiotics greatly hastens this process. There is a great deal that can and must be done to conserve the drugs that are available and still effective. Over-the-counter sales of antibiotics must be stopped. Physicians need to be educated on when it is appropriate to use antibiotics. Even when an antibiotic is needed, it is essential that the right drug is given at an adequate dosage and for a suitable duration. A proper system of surveillance for antimicrobial resistance as well as regularly updated guidelines for treatment would help doctors make the right choices. Further, the use of antibiotics as growth-promoters in livestock needs to be curtailed. In all of this, the government, the medical fraternity, and the public must play their part.
Keywords: World Health Day, drug-resistant pathogens, antibiotics, superbugs
In 1998, in the United States, 80 million prescriptions of antibiotics for human use were filled. This equals 12,500 tons in one year. It has become a norm for individuals to take a pill for every other ailment without actually understanding its adverse effects.World health day has come down with a strong message to take the wakeup call the earliest.Our rural areas worst hit of this unchecked usage of drugs.Availibility is the key issue, for which the invincible step should be proper prescription by a trained medico.India already has 3 million cases of T.B and 73,000 with Multi-drug resistent TB (MDR-TB) So the effect is getting amplified.
The threat of 'superbugs' hanging on the citizenry is veritable and is going to stay here. Mutation may be one of the factors that promotes the possibility of the emergence of the antibiotic-resistant microbes. This is well evident from the fact we see in the case of mosquitoes and other prurious insects that keep becoming gleefully immune to the pesticides we use. There are gross mis-steps in the matter of ordinary people fetching medicare. The so-called retinue of lab tests, many of which are not warranted, acts as deterrent to the patients' tendency to go the clinics. Instead, they rely on over-the-counter supply by the medical shop owners, the majority of whom are mere charlatans. Due to unhelpful and adverse living conditions, many are unable to adhere to and complete the prescribed regimen of treatment. A subsequent exposure to the same medicines may make them resistant to the curative effects of the latter. All said and done, medicare should be with in the reach for the ordinary people so that the blemish that 'modern medicine is a murderous mockery' can be erased.
May be we need to look towards the natural way of treatment again. Unlike modern science of medication, based on attacking the disease-causing bacteria , Natural therapies like Ayurveda , Yunani , Homeopathic , and even Yoga are more reliable. There is no danger, of medicine getting ineffective because of resistance developed by the microbes, in these medical theories. This area need more attention and Research. There is no doubt that in present scenario, where life is too fast , we have lesser time to exercise and to spend in lap of nature . Present life style is also a reason of increased rate in diseases caused by stress, hypertension etc . Focusing over the root cause of problems and controlling them are also a way to reduce the chances / cases of problem. It is rightly said that prevention is better than cure.
As one has less control over the movement of bugs or superbugs from other places one can prevent the bacterial infections by personal cleanliness .Much can be done by maintaining hygiene in most places especially the rural ones.. A lot of places still see people defecating on roads and nearby their homes.These kind of activities actually increases the infections and must be prevented. A lot is seen in places near BKC Mumbai ,which is supposed to be one of the famous commerce location of Mumbai. Until and unless cleanliness is maintained nobody can expect a germ free place.This is not the only solution and lots can be done to prevent diseases but atleast everyone can be expected to contribute their part and start by primary steps like this.
Hindu's editorial has aptly brought out the impending disaster the drug resistance is going to cause. Misuse of antibiotics hasten the development of drug resistance is absolutely correct; but who is involved in misuse and how is this to be corrected is the million dollar question to be analyzed and controlled by the four pillars of our democracy. It's mandatory that the medical fraternity must keep abreast of their knowledge about the recent trend of behavior of the virulent organisms. In a situation where the usage of antibiotics prescribed by the quacks and non-allopathic physicians is more than the prescriptions given by the qualified physicians, monitoring the surveillance of resistant organisms will become a Herculean task. If the menace of quackery is rooted out from our country, major causative factor of this juggernaut can easily be overcome. Secondly an ordinance must be promolgated that pharmacists should not honor prescriptions of antibiotics which have improper dosage schedule and duration. Thirdly, media should create an awareness among public about the dangers of self medication leading on to drug resistance and its fatal consequences.
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