Article Anti bodies are failing: High resistance in bacteria

[Technoglitch]

How is the antibiotics resistance problem different in India considering that the problem stems more from overuse, misuse and erratic administration? Also, given that those that have developed resistance can still be useful, which should be the preferred antibiotics in India?

A. Globally, antibiotic use (both appropriate and inappropriate) is the major driver of antibiotic resistance. In contrast to developed countries, in India antibiotics are available without prescription resulting in widespread misuse. In addition, once resistance emerges, resistance can spread among bacteria very quickly in India because of poor sanitation (e.g. lack of safe drinking water, overcrowding, etc.) in the community and poor implementation of infection control practices in hospitals. Limited data available from published studies in India indicate high resistance among various bacteria-causing common infections. Bacterial infections burden in India is among the highest in the world and antibiotics play a major role in preventing deaths. High antibiotic resistance rates would thus lead to huge adversehealth outcomes.

Regarding preferred antibiotics in India, the choice of antibiotic depends on type of infection and the extent of resistance in bacteria causing these infections. Unfortunately, there are no national level data on resistance to guide physicians on appropriate choice of antibiotics for common infections. In general, narrow spectrum (active against a selected group of bacteria) antibiotics should be used over broad-spectrum (active against a wide number of bacteria) antibiotics whenever possible.

Q. How should we prevent the misuse of newer antibiotics? In India, which are the new generation antibiotics that are being by pushed by pharmaceutical companies?

A. Restricting the availability of newer antibiotics without a prescription and establishing antimicrobial stewardship programmes in hospitals are important steps to prevent misuse. In addition, widespread public campaigns aimed at the general public and chemists are necessary to increase the awareness of antibiotic resistance and encourage appropriate use of antibiotics. To prevent over-the-counter sales of important antibiotics, the Indian government included certain antibiotics in Schedule H1 category starting March 1, 2014. Schedule H1 covers 46 drugs and includes 24 antibiotics, such as third- and fourth-generation cephalosporins, carbapenems, anti-tuberculosis drugs and newer antibiotics like linezolid. Under this schedule, the chemist should retain the prescription copy and maintain a record of the patient and the prescriber details. The retail pharmacies are subjected to surprise inspections by state drug inspectors to check for violations. However, there is an absolute need for full enforcement of this provision in pharmacies to curb misuse.

Q. How does India compare with other countries?

A. In 2010, India was the highest consumer of antibiotics followed by China and the US. Overall retail antibiotic consumption increased by about 68 per cent from about 7.7 billion antibiotic pills in 2000 to about 12.9 billion pills in 2010. In 2010, consumption of last-resort antibiotics (carbapenems) is significantly high compared with other developed countries like the US or the Netherlands and the consumption of these last-resort antibiotics is increasing rapidly.

This is indicated below in the chart taken from the paper Antibiotic resistance-The need for global solutions http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(13)70318-9/abstract


'Data in India indicate high resistance among bacteria-causing common infections' - Business Today

 

[Technoglitch]

The doctor's office is another place the panelists focused on as an area where antibiotic drugs are often misused. Laxminarayan explained that the prescription for an antibiotic has become the "ticket" to ending a hospital visit for both doctors and patients, so there is a lot of incentive to write one on the first visit to the office. Historically there has been no harm in prescribing this type of drug before knowing the exact nature of the infection in the patient, and patients have come to expect an easy prescription. But now that antibiotic resistance has become such an issue, both doctors and patients need to be more hesitant about prescribing antibiotics routinely.

Creating new medications was discussed as a primary way to combat this issue, however, pharmaceutical companies are hesitant to invest in these drugs because they do not generate great financial returns, Fauci said. "Antibiotics are not a blockbuster item," he said. "New lipid-lowering agents, new Viagras, new hypertension drugs are blockbusters because millions of people use them every day, whereas antibiotics are used in seven- or 10-day spurts." Because of this, he continued, the best way to encourage pharmaceutical companies to get involved is by "de-risking" the process and making it a more financially viable venture, which is something his organization works to do.

Why Our Antibiotics Aren't Working and What We Can Do to Fix It | Aspen Institute

 

[Ras Al Ghul]

This is indeed true.When i was in college the newer antibiotics like Piperacillin Meropenem Ertapenem Lizolid etc were just introduced in the market.7 years down the line we have bacterias which are resistant to them.It takes decades to find a acceptable antibiotic but unethical use these days is making them non effective in few years.

India esp is a hub of these.The widespread unethical unscientific use of antibiotics means India has the most strains of antibiotic resistant bacterias.

For anyone wanting to know how dangerous it is,search Delhi Bug.

 

[aumnamonarayan]

Nothing new, for many decades big companies r exploiting Indians. So many pesticides banned in USA r openly used here in agriculture. Neithet government takes action and these big companies just do what they want, corruption is the root cause if it. Already we have seen big companies bribing to get their work done in India. When there is no one who is protecting the rights of people and laws r being flouted with no checks so this is bound to rise

 

[Ras Al Ghul]

Nothing new, for many decades big companies r exploiting Indians. So many pesticides banned in USA r openly used here in agriculture. Neithet government takes action and these big companies just do what they want, corruption is the root cause if it. Already we have seen big companies bribing to get their work done in India. When there is no one who is protecting the rights of people and laws r being flouted with no checks so this is bound to rise

What do you mean by Pharma companies exploiting Indians?How are Indians getting exploited here?

 

[aumnamonarayan]

Read about it bro. Many news articles have mentioned that these big companies offer doctors many big perks to promote their products. Most times patients r advised medicines or tests when it is not needed

 

[Ras Al Ghul]

Read about it bro. Many news articles have mentioned that these big companies offer doctors many big perks to promote their products. Most times patients r advised medicines or tests when it is not needed

Marketing is done by every company in every industry.Doctors do prescribe their preferred brands yes but to day they prescribe unnecessary medications is wrong.

Secondly in todayz world when doctors are sued right left and center its only prudent that a dr prescribes tests to make sure he has evidence to back up his treatement.

Watching Aamir Khans Satyamev Jayate or reading couple of articles in paper cannot tell you tye truth.

 

[IndianMascot]

Atleast mine doctor so not prescribes unnecessary medicines.