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Mahesh

12/01/24 07:25 AM IST

Debate over Anti-biotic

In News
  • The National Centre for Disease Control (NCDC) recently found that over half of the nearly 10,000 hospital patients surveyed for a study were given antibiotics to prevent, rather than treat, infection.
Antimicrobial resistance (AMR)
  • AMR is defined as resistance of micro-organisms to an antimicrobial agent to which they were first sensitive.
  • E. coli, Klebsiella, Acinetobacter, Staphylococcus aureus, enterococcus — have even become resistant to some of the latest generation antibiotics.
  • Patients who get infections with these resistant strains of bacteria have a higher possibility of poorer health outcomes due to the resistance.
  • In 2019 alone, drug-resistant superbugs killed about 1.27 million people globally — a toll more than HIV/AIDS or malaria — and according to the United Nations’ (UN) estimates, that number could reach 10 million by 2050.
  • In India, the largest consumer of antimicrobials globally, AMR is gaining ground, and the use of last-resort antibiotics like cephalosporins is soaring.
  • The country is projected to have 1.6 million multi-drug resistant infectious cases in 2040, which is significantly higher than any country.
Reasons
  • The inappropriate use of antibiotics in non-bacterial infections, both because of prescribing practices and the use of over-the-counter antibiotics.
  • Second, inadequate laboratory facilities to inform clinicians rapidly about what would be an appropriate antibiotic even in bacterial infections, based on cultures. So, most clinicians are shooting in the dark.
  • Third, the lack of adequate training in antibiotic selection, escalation, and de-escalation.
  • Fourth, inadequate monitoring of AMR and control of antibiotic prescription and dispensing practices by health systems in spite of repeated warnings.
  • And fifth, the incentivisation of prescribing practices by the pharmaceutical industry.
  • Inadequate sanitation in the community and improper infection prevention in healthcare institutions helps spread these superbugs.
  • AMR is a complex socio-economic and political challenge and not just a scientific issue to be solved by doctors and researchers alone.
Control
  • One way to prevent the reckless overuse of antimicrobials is to diagnose what’s causing an infection early, which helps determine the right course of drugs.
  • In India, many doctors prescribe antibiotics to treat infections that are likely caused by viruses.
  • Rapid diagnostics, which can help identify the exact microbe and the drug to which they are susceptible to, can avoid antibiotic misuse at the point of care.
  • Planned expenditure, structured delivery of services, and robust accountability of the public health system are all important factors that will help.
Source- The Hindu

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