Saying no to drugs

When Lancet claimed that the New Delhi Metallo-1 superbug was a side-effect of Indian surgeries and transplants,as a result of the profligate use of antibiotics,it was much maligned by the medical community here. However,now there is further endorsement from an article published in the journal Antimicrobial Agents and Chemotherapy,which has identified bacteria resistant to the commonly used carbapenem,and declared that isolates producing NDM-1 were disseminated as early as 2006.

Appearances apart,we know only too well that India is guilty as charged as far as indiscriminate use of antibiotics is concerned. There is enough anecdotal evidence that physicians prescribe these drugs even for mild infections. Partly,this is out of an immediate concern for the patient,and partly because pharma reps incentivise them to use these drugs. India lacks effective regulation,so most of these antibiotics can be casually bought over the counter,without prescriptions. The problem is that the more you use antimicrobials,the less effective they become because they encourage bacteria to develop resistance and effectively create tougher mutant strains. Cumulatively,they do tremendous public health damage.

Certainly,India is only one among many implicated countries that make the problem of antimicrobial resistance worse. But we can,and should,begin remedial action. Recently,a group of public health experts had drawn up guidelines for government hospitals,on the appropriate use of antibiotics. They sought to underline the difference between grave and intense illness that called for strong antibiotic use,and others to be administered to out-patients. They also suggested an infection-surveillance system,an exclusive team to check cleanliness standards,etc. However,the problem will persist unless all medical care facilities are strictly monitored.