Antibiotic abuse, very alarming

The new protocol laid down by the World Health Organisation (WHO) for the use of antibiotics should help tackle the problem of anti-microbial resistance which has become increasingly serious in recent years. It has revised the list of antibiotics in its essential medicines list, in the biggest such exercise in
40 years, and grouped them into three categories with recommendations on when each category should be used. The classification is expected to reduce the indiscriminate use of antibiotics in treatment of ailments and injuries. The three classes consist of an Access group of antibiotics which can be used at all times for a broad spectrum of infections, a Watch category which is a second choice for a smaller number of infections and a Reserve group which should be used only as the last resort. The medicines in each category are listed out.

Antibiotic resistance has become a major threat to public health the world over, including India. It is resistance developed by patients to antibiotics because of their indiscriminate and excessive use. There are only a limited number of antibiotics and if they become ineffective, many major ailments will have a free run. There have even been fears that the world may return to the pre-antibiotic age. Public health authorities, the WHO and experts have issued warnings on the matter, tried to create awareness about it and taken steps to counter it. The WHO has issued global reports and held awareness weeks and other programmes on it. It has issued several advisories also and the latest guidelines are a part of such efforts. A few months ago it published a list of pathogens for which new antibiotics are urgently needed, in order to promote research and development of new medicines. 

The new advisory is intended to bring some discipline to the presc­ription and use of antibiotics so that there is no excessive and unnecessary use. The world health body has also claimed that adherence to the protocol will ensure that antibiotics are available when they are needed and that the right medicines are prescribed for the right diseases. Treatments are expected to become more effective, and the potency of last resort medicines will be preserved for situations when all others fail. The guidelines will be of use only if they are followed sincerely. The government has an important role in ensuring that this happens. The WHO has meant this when it said that the new list should help health system planners and prescribers in their work and ensure that the problem of antibiotic resistance does not get worse.