In continuation with my write up on Antimicrobial resistance a ticking
bomb [1], I am happy to announce another forward step taken by the
Academy in this direction Call to Action to tackle the antimicrobial
resistance (AMR) (Annexure I). The Indian Academy
of Pediatrics (IAP) and the Indian Council Medical Research (ICMR) came
together in the month of April 2014 perhaps for the first time to
discuss and deliberate over the magnitude of the problem, reasons and
possible solutions to tackle the antimicrobial resistance among children
in India. Dr. Katoch, Secretary HR and Director General-ICMR addressed
the meeting and rendered support from ICMR, and recommended to work out
interventions keeping in mind the local needs and constraints.
The data presented by microbiologists from different
regions of the country showed that though the magnitude of resistance is
higher in gram negative organisms, the resistance among gram positive
bacteria is also showing a worsening trend. It was noted that
most of the data presented were from the intensive care units, and there
is scarcity of representative data from the community. Indiscriminate
use of antibiotics appears to be the single most important factor
responsible for the menace of AMR. Over-the-counter availability of
antibiotics, laxity of regulatory bodies in approval of antibiotics,
lack of public awareness about antibiotic resistance and the injudicious
use in veterinary practice are some other causes. Overburdened health
infrastructure and inequity in health care are other obstacles for
rational use of antibiotics. There is also a lack of awareness about
tremendous potential of, and implementation of the infection control
policies in the small hospitals and nursing homes to prevent resistant
infections.
A 4-point plan has been chalked out with time frames
based on the above deliberations:
1. Developing and disseminating National
Antibiotic Guidelines for Children 2014 The IAP-ICMR document;
2. Educating doctors both pediatricians and
others and public on rational antibiotic practice;
3. Developing infection control guidelines for
small hospitals and nursing homes, training the owners of such
establishments and ensuring compliance by the members; and
4. Collecting and collating data on antimicrobial
resistance from the clinicians.
The tasks are challenging but not impossible. We must
aggressively chase the goal to save the antibiotics for what we know as
curatives of today.
Reference