Copyright infringement not intended

Picture Courtesy: The Hindu

Context:

The extensive use of antibiotics in health care has resulted in a rise in pathogenic bacteria and other microorganisms that are resistant to antibiotics. In the year 2021, about 1.2 million deaths worldwide were attributed to antimicrobial resistance to existing antibiotics.

Key Findings:

• According to findings from the National Centre for Disease Control (NCDC), one of the leading causes of antimicrobial resistance (AMR) is the overuse and inappropriate prescribing of antibiotics.
• A significant portion of patients (55%) received antibiotics as a preventive measure to avoid potential infections.
• Small percentage (6%) of patients were treated with antibiotics based on confirmed laboratory identification of the bacteria responsible for their illness.
• Empirical prescribing was dominant, with 94% of antibiotics administered before a conclusive diagnosis was established.
• The percentage of patients receiving antibiotics ranged from 37% to 100%, reflecting inconsistencies in antibiotic use protocols. 

What is Antimicrobial Resistance (AMR)?

Antimicrobial Resistance (AMR) refers to the ability of microorganisms—such as bacteria, viruses, fungi, and parasites—to resist the effects of drugs that once effectively treated infections. These include antibiotics, antivirals, antifungals, antimalarials, and anthelmintics. 

Factors Contributing to the Spread of AMR:

• Countries with a high prevalence of communicable diseases—such as tuberculosis, respiratory infections, and diarrheal diseases—experience higher antibiotic usage, increasing the chances of resistance.
• Limited diagnostic capabilities and laboratory facilities make it difficult to identify the exact cause of infections.
• Inadequate sanitation, overcrowding, and lack of proper hygiene protocols in hospitals and clinics allow resistant organisms to spread easily between patients.
• Excessive and inappropriate use of antibiotics—such as prescribing without diagnosis, self-medication, not completing prescribed courses, or using broad-spectrum antibiotics unnecessarily.
• Many people are unaware of the proper use of antibiotics 

Consequences of Antimicrobial Resistance:

• AMR compromises the treatment of common infections, such as pneumonia, urinary tract infections, and skin infections. In 2019, there were around 7 million deaths linked to infections, with antimicrobial resistance (AMR) directly responsible for an estimated 1.27 million fatalities and contributing indirectly to about 4.95 million more.
• Treating drug-resistant infections often involves costlier medications, prolonged hospital stays, and more complex treatment regimens.
• Medical interventions like surgeries, chemotherapy, and organ transplants become riskier due to the threat of untreatable infections.
• With more pathogens becoming resistant, fewer effective antibiotics remain available. 

Measures Taken to Combat AMR:

• National Initiatives
• National Programme on AMR Containment (2012): Strengthens AMR surveillance by equipping laboratories in state medical colleges.
• National Action Plan on AMR (2017): Promotes a One Health approach involving collaboration across human health, animal health, and environmental sectors.
• AMR Surveillance and Research Network (AMRSN): Tracks resistance trends and collects data across the country to inform treatment protocols.
• Drug Regulation: The Drug Controller General of India (DCGI) has banned 40 inappropriate Fixed Dose Combinations (FDCs) of antibiotics.
• Global Efforts
• World Antimicrobial Awareness Week (WAAW): Held annually since 2015, this WHO-led campaign promotes awareness and best practices to curb AMR globally.
• Global Antimicrobial Resistance and Use Surveillance System (GLASS): Established by WHO in 2015 to collect and analyze AMR data globally, including resistance patterns, antibiotic usage, and environmental factors. 

Way Forward:

• Public Awareness and Education: Conduct large-scale campaigns to inform people about the risks of AMR. 

• Strengthen Antibiotic Stewardship: Hospitals and clinics should adopt stewardship programs to monitor and regulate antibiotic use.  

• Enforce Regulations on Antibiotic Sales: Restrict over-the-counter antibiotic sales by mandating prescriptions to prevent inappropriate use. 

• Invest in Research and Innovation: Support the development of new antibiotics, alternative therapies like phage therapy, rapid diagnostics. 

• Expand AMR Surveillance: Establish an integrated national surveillance system to monitor AMR trends across human, animal, and environmental sectors. 

Source: The Hindu