Dr Neeraj Adkar, Joint Replacement Surgeon and Sports Medicine specialist, Saishree Hospital in Aundh, Dr Narendra Vaidya, MD and Chief Joint Replacement Surgeon, Lokmanya Hospital, Dr Vikram Padbidri, Consultant – Microbiology and Infection control, Jehangir Hospital, talk about why there is a need to prevent rampant use of antibiotics
Death of a Nevada (US) woman due to superbug to which she was resistant to all antibiotics recently spread panic waves throughout the world. Now, the World Health Organisation has published its first ever list of priority pathogens – a catalogue of 12 families of bacteria that pose a great threat to human health. Bad news for the country and hence the city is that most of these superbugs are already found to be present here.
“The main reason why antibiotic resistance develops is rampant use of antibiotics not only at the hospital level, but also OPD level. Sometimes, these are prescribed without giving much thought or exercising caution. This results in unnecessary prescription of higher antibiotics. There is a need for a hospital infection committee at every hospital which should also contain microbiologists which will govern this,” informed Dr Neeraj Adkar, Joint Replacement Surgeon and Sports Medicine specialist, Saishree Hospital in Aundh.
Referring to Chennai Declaration where a joint meeting of medical societies in the country and prominent doctors and researchers had congregated in the year 2012 to discuss this issue, Dr Adkar said, “Despite the meeting, there has been no action taken on it.”
As we enter in post-antibiotic era, the list was drawn up by the international health body to promote research and development of new antibiotics considering that the present ones seem to be at the end of their life. Considering that the market of these drugs is not lucrative, newer antibiotics are not being developed. Therefore, WHO is of the opinion that if it is left to market forces alone, newer antibiotics which are needed to be developed urgently will not be developed.
Dr Vikram Padbidri, Consultant – Microbiology and Infection control, Jehangir Hospital has hailed this move. “It is a good move by WHO to release a list of the high priority pathogens, as infections caused by these organisms are and will continue to be a major cause of sickness and death. Whether companies do invest in R&D remains to be seen. But what is more important that this should serve as a wake up call for all of us, as it is more important that we continue to practice judicious antibiotic use and infection control measures in our hospitals to minimise the emergence and spread of these pathogens. It is better to do what is in our hands, rather than be hopeful of what might not be. Hospitals all over India, not just in Pune are coming across these pathogens. Indiscriminate use of antibiotics and ability of the bacterium to adapt and develop resistance to the antibiotics. Indiscriminate use of antibiotics like taking antibiotics for viral infections like common cold, influenza etc, not adhering to a course of antibiotics prescribed by a doctor, omitting few doses, self medication, etc,” he said.
Referring to the Chennai Declaration, Dr Padbidri said, “It is too early to tell if it has helped, but it is a step in the right direction. Regulation of antibiotic usage in poultry and agriculture and good infection control measures in hospitals can help to combat this problem.”
“India is a hub for infectious diseases including viral, bacterial and fungal infections. Judicious use of antibiotics is the mainstay for treatment of these infections. Aggressive marketing of newer antibiotics, lack of policies on antibiotic usage, inadequate knowledge about pharmacology of these drugs and inadequate therapy are the main reasons that contribute heavily for developing resistance against that particular drug. This means that the antibiotic which was initially effective later becomes useless for that infection due to the resistance developed by the bugs. Presently, resistant infections is a huge problem in case of critical patients. If we do not address these issues, we may lose precious lives especially patients on ventilator. Strategy to tackle these superbugs has to be comprehensive and has to include awareness among the general public. Western nations have been driving strong public campaigns against indiscriminate use of antibiotics. In our country too a meeting of various medical associations, government organisations and all the stake holders was held in Chennai wherein a five-year policy has been framed,” informed Dr Narendra Vaidya, MD and Chief Joint Replacement Surgeon, Lokmanya Hospital.