While resistance to antibiotics has always been a global threat,New Delhi Metallo-1 (NDM-1) has shifted the spotlight on how Delhiites use,or abuse,antibiotics. A survey of five municipal wards of the Capital,conducted between 2004-2008,revealed the superbug has been in the making for decades.
According to the survey,nearly 70 per cent of Delhis private doctors prescribe antibiotics for ailments that did not require such therapy. It has been evident for a while that the superbug,or resistance,is a direct result of over-the-counter prescriptions given by doctors. This is a problem specific to developing countries,which is why the UK authorities have named India, said Dr Anita Kotwani,Associate Professor at VP Chest Institutes Department of Pharmacology.
The study funded by the World Health Organisation focused on retail outlets and interviewed patients in the municipal wards of Inderpuri,Karol Bagh,Patel Nagar,Rajinder Nagar and Rajouri Garden in 2008. The findings were published in the Indian Journal of Medical Research in May 2009 and presented by Dr Kotwani at the Harvard Medical School last October.
The study looked specifically at patients with diarrohea and respiratory infections,who did not require any antibiotic therapy. Despite this,nearly 70 per cent of the patients were prescribed antibiotics by private practitioners while 40 per cent government doctors were prescribing unnecessary antibiotic doses.
There is a dire need for surveillance of antibiotic use,its misuse and resistance. This is the time to start educational intervention,which means doctors should not be prescribing antibiotics,especially for conditions like influenza and common cold which do not require any therapy, said Dr Kotwani.
Dr V M Katoch,Director General of the Indian Council of Medical Research,also agreed that it was time to change the Indian mindset. Though antibiotic resistance is a global phenomena,it cannot be denied that we indiscriminately abuse antibiotics. This issue will have to be addressed in a scientific manner,which will require constant debates and awareness campaigns in the community. Legislative pressures might be needed to usher in behavioural change, he said.
According to experts,the increased resistance is a result of the overall volume of antibiotic consumption. When a community overuses a particular drug,the bacteria evolves enough to not be effected by the drug anymore. This is a common phenomena worldwide. Given the lack of data in our community and easy access to drugs without prescriptions,the problem becomes ominous, said Dr N P Singh,Professor of Medicine,Maulana Azad Medical College (MAMC).