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In his recent ‘Mann Ki Baat’ programme in All India Radio, Prime Minister Narendra Modi has expressed concern over the severe threat posed by antibiotic resistance, citing alarming evidence from the Indian Council of Medical Research (ICMR). The study by ICMR revealed that Klebsiella pneumoniae and Acinetobacter baumannii, two topmost pathogens responsible for causing bloodstream infections (BSIs) which is the most common hospital-acquired infection, showed resistance to antibiotic imipenem among ICU patients with BSIs. Besides, two other pathogens Staphylococcus aureus and Enterococcus faecium causing BSIs were resistant to antibiotics oxacillin and vancomycin, respectively. A high resistance rate was also noted in bacteria causing urinary tract infections (UTIs) and pneumonia. A high rate of resistance was seen among UTI causing E coli and Klebsiella pneumoniae and Acinetobacter baumannii against antibiotics carbapenem, fluoroquinolones and third generation cephalosporins. The study further revealed that antibiotics like piperacillin-tazobactam and carbapenems, which are used for treating blood infections caused by E coli bacteria, have been found to be more resistant among OPD, ICU and ward patients over the last seven years. In Acinetobacter baumannii, one of main pathogens of the hospital acquired infections such as pneumonia, there is no significant change in the susceptibility trends to all the tested antibiotics compared to 2022. The study also found that resistance to carbapenems in Acinetobacter baumannii was recorded as 88 per cent in the year 2023, limiting the availability of available treatment options. In view of the study results, the country’s top health research agency has recommended to the Union Health Ministry and the Drug Controller General of India that antibiotics newly launched in the country should only be sold through certain hospital pharmacies, amid concerns around their misuse and abuse and an alarming increase in resistance to critical antibiotics, including last-resort treatments.
Apparently, another healthcare catastrophe is looming large on the horizon as the world today is literally standing on the edge of a post-antibiotic era - a world without antibiotics, in which illnesses from minor throat infections to serious illnesses like cholera, tuberculosis, pneumonia, etc will become untreatable. There are no two opinions among the medical fraternity about the fact one of the major health problems being faced by the country today, for that matter the entire world, is antimicrobial resistance, also known as AMR.
And this is not the health crisis of the present generation alone, as it is going to be the biggest health crisis of the next generation too, if not tackled in time. Experts world over have already red flagged over the looming grim situation of a world without antibiotics, if necessary steps are not taken immediately. Even though AMR also occurs naturally over time, indiscriminate and incorrect use of antibiotics are the major reasons for the emergence of AMR. It occurs when micro-organisms, including bacteria, viruses and fungi, evolve to resist the drugs that would otherwise kill them. Unnecessary antimicrobial use in humans and agriculture exacerbates the problem. The hard fact is fact, misuse and overuse of antibiotics are threatening to undo decades of medical progress. It is often observed that the availability of these life-saving medicines over-the-counter makes matters worse as people tend to purchase antibiotic drugs even for illnesses which are due to a virus rather than a bacterium. When antibiotics are so readily available, there is no imperative for them to be treated with the care they need. As the Prime Minister highlighted in the ‘Mann Ki Baat’ programme, the situation no doubt is alarming. Concerted efforts are the need of the hour to combat this growing crisis of AMR.
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