Wanted: a policy on antibiotics

It needed a scare like NDM-1 for the country to wake up to a policy to
regulate antibiotics. But after announcing with much fanfare that a
policy would be in place, the government withdrew thedecision. We have
arrived at a crossroads and there is no solution to the crisis yet.
Organisations comprising medical practitioners across the country will
come together in Chennai on August 24 to discuss the possibility of
evolving a road map that will help the government prepare and
implement an antibiotic policy. Physicians, surgeons, gynaecologists,
oncologists and representatives from the World Health Organisationand
Medical Council of India will deliberate on the need to evolve an
antibiotics policy.
The approach to treating diseases changed after Alexander Fleming's
accidental discovery of penicillin. It was this discovery that saved
hundreds of wounded soldiers during World War II. What began in the
1940s turned into a flurry of activity, leading to manufacture of a
large number of antibiotics. But soon, everything changed. Today the
number of antibiotics manufactured across the world has
fallendrastically and adding to the woes is the fact that its
unchecked use has resulted in bacteria developing resistance to
several antibiotics.
Across the world, every country has been battling the antibiotic
resistance war. Antibiotic resistance would mean that 2.5 million
deaths would occur due to infections. Simply put, resistance would
mean no more drugs and back to the pre-Fleming days. While other
nations have formulated a policy, India has done nothing, says Abdul
Gafur, Indian coordinator of World Alliance Against Resistance, who
will also coordinate the roadmap meeting in the city.
What will happen if antibiotics fail? Usually, a doctor would
prescribe alternatives to an antibiotic if the patient is found
resistant to one set of antibiotics. But rampantmisuse of antibiotics
has resulted in patients developing resistance to several antibiotics,
Dr. Gafur says. The problem is compounded in countries where animals
have been fed antibiotics and eating the cultivated meat has passed on
resistant strains of the bacteria to humans.
Some large hospitals in the country follow a routine of culturing
bacteria taken from patient samples. When a patient exhibits
resistance to a set of antibiotics, she/he is isolated and an
infection control protocol to prevent the next patient from acquiring
resistance is followed. Thisprotocol should be made mandatory for all
hospitalsseeking accreditation fromthe National Accreditation Board
for Hospitals, Dr. Gafur says.
While doctors and smaller hospitals and clinics should follow simple
prevention steps such as washing hands between examining patients,
wearing gloves and apron while treating a patient with resistant
bacteria, larger hospitals should have a vibrant infection control
cell, and a policy for rational use of antibiotics. "What we are doing
now is crisis management. India needs a practical antibiotics policy
which can initially be liberal and later be made stringent," Dr. Gafur
says. All countries are sailing in the same boat. But while some
developedcountries have started evolving a policy, India is merely
observing the situation. A country that has been promoting medical
tourism should pay attention to the crisis,