NEWS FROM THE HINDU
Antimicrobial resistance: clear and present danger:
After years of doing little to tackle the silent but potentially deadly proliferation of antibiotic-resistant bacteria in India, all hell broke loose in 2008, when New Delhi was tacked onto the name New Delhi Metallo Beta-lactamase-1(NDM-1) an enzyme make virulant antibiotic resistant strains discovered in New Delhi in 2008.The bug is highly resistant to all beta lactamase antibiotics such as Penicillins,and cephalosporins.
Only after the detection of the New Delhi Metallo-beta-lactamase-1 super bug, India sat up to the danger of anti-microbial resistance within its boundaries, and is beginning to understand the disastrous societal consequences of rendering certain life-saving drugs impotent. Photo: Special Arrangement
India awoke late to risks of antibiotic overuse and is scrambling to contain the surge in drug resistance.
After years of doing little to tackle the silent but potentially deadly proliferation of antibiotic-resistant bacteria in India, all hell broke loose in 2008, when New Delhi was tacked onto the name of a one such bug.
The New Delhi Metallo-beta-lactamase-1 was an enzyme that rendered bacteria resistant to a broad spectrum of antibiotics. A strain of the NDM1 had crossed the shores and spread resistance in the U.K. as well.
Despite its outrage over being associated with a resistant bug the nation sat up to the danger of anti-microbial resistance within its boundaries, and is beginning to understand the disastrous societal consequences of rendering certain life-saving drugs impotent.
Prior to the detection of the NDM, isolated calls for regulating antibiotics use were being made by doctors in surgeries and those manning Intensive Care Units.
It was in 2011 that the Union government came up with a National Policy for Containment of Antimicrobial Resistance in India, seeking to reverse what seemed to be spiralling healthcare concern.
The policy makes no bones about recognising the real threat: “Antimicrobial resistance in pathogens causing important communicable diseases has become a matter of great public health concern globally including our country. Resistance has emerged even to newer, more potent antimicrobial agents like carbapenems.”
A March 2016 paper on ‘Antibiotic Resistance in India: Drivers and Opportunities for Action’ in PLOS Medicine makes a convincing case for action against resistance: “Antibiotic resistance is a global public health threat, but nowhere is it as stark as in India. The crude infectious disease mortality rate in India today is 416.75 per 100,000 persons… twice the rate in the U.S. (200) when antibiotics were introduced.”
Among the key factors responsible are the widespread use and availability of practically all the antimicrobials across the counter, increasing and wanton use of antibiotics in livestock production, inappropriate doses, and irrational use of antibiotics in hospitals.
Attempts have begun to regulate at least the human consumption of antibiotics: there are now guidelines for appropriate antibiotics usage which have revised Schedule H drugs to make over-the-counter availability of certain antibiotics nearly impossible.
Stringent enforcement of drugs control, making the dispensing of some antibiotics over the counter punishable, is the need of the hour.
Comment
Antibiotics are wonderful medicines to give relief from various infections.But they should be handled very carefully.They should be prescribed only by professionals.In many developed countries and some countries in the third world such as in UAE (Abudhabi) antibiotics have been already labelled as 'only by prescription' medications.Abudhabi has a well designated and highly controlled medical authority known as Health Authority of Abu Dhabi (HAAD)
In these countries antibiotics are semi controlled and should be kept in separate racks away from the OTC medicines.Pharmacists are not allowed to dispense antibiotics.
Doctors are also not advised to overscribe any antibiotic as resistance may develop and put the patient in danger.
Before prescribing antibiotics to a patient the patient should be thoroughly consulted about his past history of tolerance for antibiotics.Patients should submit all the details of his past history and treatments to the present doctor.
Remember any drug can produce unwanted side effects if they were over used.Because a drug is a substance which would yield the desired effect by affecting or changing the physiology of your body.
Similarly antibiotics also they give the required releif by affecting many physiological aspects of your body.For example chloromycetin a old fashioned drug used to treat salmonella typhi,an organism that causes typhoid fever,was killing not only the organism but kills everything else that crosses infront of it including your red blood cells.Hence the drug is mostly withdrawn from use.
Antibiotics are safe if used with care.
But in India especially in Tamilnadu a peculiar state of bureaucracy and corruption with a recorded mal practices of nearly 10 years dispensing of expired medicines, antibiotics are vehemently misused and over prescribed in pharmacies,clinics and even in I/Care of big hospitals.
Recently a lady doctor was arrested in Tamil nadu as she has impersonated with a dead person's mark sheet to get a medical seat.We do no know still how many of such fraud doctors are practicing in the state unnoticed.
General precautions of Antibiotic Use:
1.Be sure that you are not allergic to the antibiotic.
2.After you start the course of antibiotics please complete the full course as per your doctor's prescription.Do not stop it in the middle of the course even if you get complete relief.Bacterias are very clever and become silent and calm at the middle of the course but when you stop the medication they become more strong and virulence by a process of mutation and resist the antibiotic.
3.Take the medicines in time.
4.Many antibiotics are effective in empty stomach but may be unfriendly to the stomach.In that case take it 1 hour before food or 2 hours after food.
