Do you know the deaths in USA because of antibiotic resistance is more than 50000 and about 700000 in world. To understand this grim problem its mitigation and way forward, I have tried and explained the situation in simple terms. The situation in our country is more alarming.
According to Stephen Lewis ;
Mumbai is India's epicenter of multi-drug resistant TB, representing 11.5 percent of the country's 147,000 cases. The success rate for curing MDR-TB, as it's called, is only 33 percent. "I would have thought that figure should ring the loudest alarm bell of all. It is unconscionable that this situation should continue,"
World health organization changed its policy recently about antibiotics protocol to curb antibiotic resistance. This is the one of the important revision of the antibiotic section in the essential medicines list by WHO.
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What is antimicrobial Resistance (AMR).
When pathogenic microorganisms such as viruses, bacteria, fungi and other parasites changes their response to the antimicrobial medications used to cure the infections and causing them ineffective.
It is the a wider term used for resistance in different types of microorganisms and encompasses resistance to antiviral,antibacterial, antifungal and antiparacitic medications. It occurs naturally by adoptation but is also facilitated by the inappropriate use of antibiotics
Microorganisms because of mutation become resistant to most antibiotics are often called as superbugs. It affects the, medical procedures such as organ transplantation, cancer chemotherapy, major surgeries etc. making them very risky because antibiotics are essential for the said post procedure treatment.
WHO (World Health Organization).
It is a one of the specialised agency of UNITED NATION concerned with world public health. WHO was established on 7 April 1948, headquartered based in Geneva, Switzerland. The WHO publishes World Health Report annually.
WHO's Global action plan on antimicrobial resistance 2015.
The main 5 objectives were:
- To improve awareness and understanding of antimicrobial resistance.
- To strengthen surveillance and research.
- To reduce the incidence of infection.
- To optimize the use of antimicrobial medicines.
- To ensure sustainable investment in countering antimicrobial resistance.
The other antimicrobial initiatives are;
- One health approach.
- World Antibiotic Awareness Week.
- The Global Antimicrobial Resistance Surveillance System.
- Interagency Coordination Group on Antimicrobial Resistance.
WHO'S revised antimicrobial protocol.
WHO has classified the antimicrobials into three categories:
1 access,
2 watch and
3 reserve.
The ACCESS type includes commonly used antimicrobial, over the counter antibiotics. They will be utilized at all times as treatment for a wide range of commonly found infections.
The WATCH group antibiotics that are recommended as first or second choice treatment for a limited number of infections. Prescription of these drugs should be reduced to avoid further development of resistance.
The RESERVE category includes those antibiotics that are considered last option used only in the most severe circumstances such as for life-threatening infections due to multidrug-resistant tuberculosis.
Indian Initiatives.
Recently,Indian Ministry of Science - Technology have released the Scoping Report on Antimicrobial Resistance in India.
The Highlights of the report
Till the year 2014, India was at highest in consumption of antibiotics, followed by China and the United States of America but the per capita consumption of antimicrobials in India is much lower than several other developed countries.
India has some of the highest antibiotic resistance rates among bacteria that commonly cause infections among the community and hospital facilities.
It has also pointedout that the resistance to CARBAPENEM class of antibiotics, one of the last-resort antibiotics to treat serious bacterial infections in humans, among various bacteria was alarmingly high.
Antibiotic-resistant bacterial infections are also highly reported among neonates and animals.
Factors responsible for antibiotic resistance in India.
- Self-medication, In poor countries self medication is common to avoid financial burden.
*Over the counter availability or access to antibiotics without prescription. - illegal practices by pharmacies and informal healthcare providers as sources of healthcare.
- Lack of funds and technologies in public sector diagnostic laboratory and Unaffordability of private labs.
- Judicious useof Antibiotics as growth promoters in vaternary science animals husbandry and poultry.
- Effluents or wastage from antibiotic manufacturing units leading to contamination of soil, rivers, seas and lakes
- Improperly managed Disposal of untreated sewage into environment and water bodies
- Prevalence of various Hospital Aquire infections(HAI).
It is not only the government or WHO but civil society as well as every individual who needs to be sensitized for the better management of infectious diseases.
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