Introduction

  • All of us know what antibiotics are, in fact, whenever we suffer a severe infection, our medical practitioner prescribes these powerful medicines to help us fight the infection caused by bacteria.
  • Also known as antimicrobial drugs, antibiotics have saved countless lives since 1928 – when penicillin, the first antibiotic, was used by doctors. But, over the years, the misuse and overuse of these drugs has contributed to a phenomenon known as antibiotic resistance.
  • This resistance develops when potentially harmful bacteria change in a way that reduces or eliminates the effectiveness of antibiotics. The world is heading rapidly towards a post-antibiotic era, in which common infections will once again kill.
  • As per a UN report, at least 7,00,000 people die each year due to drug-resistant diseases currently. By 2050, this number could go up to 10 million.  It sounds alarmist, but that’s the harsh truth brought to the fore by the World Health Organisation.
  • The efficacy of the world’s antibiotics is quickly decaying, the drugs we are using to treat infections are working less and less. In India too, a recent study states that two out of every three healthy Indians are resistant to two major types of antibiotics.
  • Clearly, if we continue at this rate without intervention, we may find that there is not a single antibiotic left to treat any type of bacterial infection

Antibiotics

  • An antibiotic is a type of antimicrobial substance active against bacteria and is the most important type of antibacterial agent for fighting bacterial infections.
  • Antibiotic medications are widely used in the treatment and prevention of such infections.
  • They may either kill or inhibit the growth of bacteria.
  • A limited number of antibiotics also possess antiprotozoal activity.
  • Antibiotics are not effective against viruses such as the common cold or influenza; drugs which inhibit viruses are termed antiviral drugs or antivirals rather than antibiotics.
  • Antibiotics are medicine used to treat infections caused by bacteria. Antibiotic Resistance refers to resistance developed by bacteria against antibiotics or the ability of bacteria to mutate or change so as to resist the effects of antibiotics. The more we use them, and the more we abuse them, the less effective they become.
  • Antibiotics are unquestionably useful against bacterial infections. However, indiscriminate use has resulted in development of resistance in patients with bacterial infections thereby leading to long lasting illnesses.
  • Thanks to that annoying thing called evolution, bacteria are constantly adapting to counter-attack antibiotics. Antibiotic resistance is one of the most significant threats to patients’ safety. It is driven by overusing antibiotics and prescribing them inappropriately.

Key findings

  • India is one of the top users of antibiotics.
  • The private sector clocked high levels of antibiotic prescription rates (412 per 1,000 persons per year).
  • The highest rate was seen among children aged 0–4 years (636 per 1,000 persons) and the lowest in the age group 10–19 years (280 per 1,000 persons).
  • Per-capita antibiotic consumption in the retail sector has increased by around 22% in five years from 2012 to 2016.

Government Initiatives

  • National Programme on Containment of Antimicrobial Resistance was launched under the 12th Five-year Plan.
  • The Union health ministry is set to roll out prescription audits as part of a multi-pronged strategy against anti-microbial resistance (AMR).
  • The health ministry, along with WHO, has worked out a national action plan to combat antibiotic resistance.
  • The campaign — ‘Medicines with the Red Line’, which involves packs of certain medicines carrying a ‘red line’ to differentiate them from other drugs.
  • Indian Council of Medical Research has issued new national guidelines on the use of Antibiotics.
  • Public awareness messages on state-run radio channels cautioning patients against taking antibiotics without a prescription

Concerns

  • Antibiotic resistance is already one of the biggest health risks and is estimated to kill 50 million by 2050 worldwide.
  • The threat continues to escalate globally because more than 50 per cent of antibiotics in many countries are used inappropriately such as for treatment of viruses when they only treat bacterial infections or use of the wrong (broader spectrum) antibiotic.
  • Besides, reduced access to effective and appropriate antibiotics in many low- and middle-income countries contributes to childhood deaths and lack of funding and implementation of national plans to tackle antimicrobial resistance.

Way forward

  • Poultry:
    • Ban the use of antibiotics for growth promotion and mass disease prevention. It should only be used to cure the sick animals based on prescription of veterinarians
    • There is a need to introduce a labelling system wherein poultry raised without use of antibiotics should be labelled through reliable certified schemes to facilitate consumer choice.
  • Rationalizing antibiotic use to limit antibiotic resistance in India.
  • Improving regulation of drug production and sale
  • Encouraging behavior change among doctors and patients are of immediate priority.
  • Regulation of the medical sector, particularly in the prescription of medicines.
  • Improved management of the health care delivery systems, both public and private, will minimize conditions favourable for the development of drug resistance.
  • Improved awareness of antimicrobial resistance through effective communication. WHO’s World Antibiotic Awareness Week is one such event.
  • Reducing the incidence of infection through effective infection prevention and control. As stated by WHO, making infection prevention and hand hygiene a national policy priority.
  • Discourage non-therapeutic use of antimicrobial agents in veterinary, agriculture and fishery practices as growth-promoting agents.
  • Promoting investments for antimicrobial resistance activities, research and innovations
  • Strengthening India’s commitment and collaborations on antimicrobial resistance at international, national and sub-national levels.
  • Regulate the release of antibiotic waste from pharmaceutical production facilities and monitoring antibiotic residues in wastewater.
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