Docs for policy on antibiotics

 Professor and Head of the Neuromicrobiology Department at Nimhans Dr R Ravikumar said: “There will be a day when we will run short of antibiotic drugs for all our infections.”  
He said, “We need to have a stringent 'antibiotic policy' framed by the health departments to curb resistance to antibiotic drugs.  It is very important to take these drugs through a prescription only and not be to be sold across the counter which is very common in our country," he said.

Dr Ravikumar said patients normally tend to discontinue antibiotic drugs prescribed to them by not completing the entire course.

This leads to resistance to the drug in future where the infection was not cured in the first place allowing the bacteria to incubate inside the body, he said.

Side effects

Another reason for a patient to discontinue the drug is the tiring side effects of the drug where a person feels better after one dose of the drug and ceases to complete the entire course, he added.

An antibiotic policy will emphasise avoiding the use of powerful antibiotics in the initial treatments. The policy creates the awareness of sparing the powerful broad spectrum of drugs for later treatment. Antibiotics should not be used casually there by reduce the antimicrobial resistance.

State Health Secretary E V Ramana Reddy agreed that as of now, there is no antibiotic policy and such drugs must not be given across the counter without prescription.
 “Though health is a state subject, the Central Government should take initiative in framing antibiotic policy under the Drugs and Cosmetics Act,” he said. 

Superbug

Reacting to the 'Superbug' episode, Dr Ravikumar said unless a new therapeutic approach is invented, more people will develop resistance to the available antibiotic drugs.

Revealing details of the findings at Nimhans, he said their tertiary care hospital had found the cases with resistance to Carbapenem group of antibiotics (Bacteriological resistance pattern study-not molecular study) long before Lancet Infectious Diseases had published about the same.

He said their department had found several patients in their hospital who had developed resistance to few high end antibiotics. 

However, he added that there are less than one per cent cases in the community who have developed resistance to antibiotics.

Nimhans is planning to conduct the gene study on their finding once the probes/ primers (strand of nucleic acid that serves as a starting point for DNA synthesis) are procured.

Rational use of antibiotics emphasised

The Superbug findings in an article published in the Lancet Journal may have caused an outrage in the healthcare industry in India and had attracted criticism from the Union Health Ministry. However, the doctors at M S Ramaiah Hospital emphasise that irrespective of the findings, doctors and patients should be made aware of rational use of antibiotics.

Dr Indumathi, Chief Microbiologist of the hospital, said Superbugs were bacteria which developed resistance to multiple antibiotics. Antibiotics should never be taken for viral infection like flu or cold as they don't work, she said.

“People should be made known that they should not self medicate or take medicines prescribed for others. Even doctors should use clinical judgment in prescribing antib-
iotics,” she said.

Interestingly, the hospital has formed an antibiotic policy, which specifies guidelines to physicians. Regular audits are also done, where the Hospital Infection Control Committee questions the doctors if they have deviated from the prescribed guidelines of treatment for a certain illness or disease.

“We have been implementing the policy for the last two years. We have had 90 per cent compliance record till date,” said Committee Chairman Dr D C Sundaresh. The committee was also planning to create another policy with the help of specialists for specific antibiotic use in certain infectious diseases within a month, he added. 

The Committee is formed by hospital administrators, doctors from the Microbiology Department, nursing superintendent, infection control nurses and representatives from the Clinical Department.