- The healthcare infrastructure in the Indian context is a work in progress despite the pandemic challenges forcing the authorities to invest time, money, and resources to spruce up is quite evident. The challenges galore faced by the healthcare authorities to save precious lives during the ravaging pandemic times are still fresh in the minds of the people. The unavailability of drugs, beds, life-saving oxygen, and medical professionals was stark during those harrowing months. That the medical fraternity could render yeoman services despite facing several challenges speaks volumes about the dedication displayed by the professionals.
PC: Kate Monica
- Further, the shortage of critical drugs during the pandemic forced the authorities to regulate the distribution and availability of the same to reach the maximum. We all saw how the pharmacists were asked to make note of the people procuring drugs being disbursed, especially concerning flu-like symptoms, when certain medicines went out of stock as the demands kept soaring. Indian citizens are also used to procuring specific medicines, including the anti-biotics, over the counter and without prescriptions from a registered medical doctor. We all become medical experts even though self-medication is known as something to be avoided at all costs.
- In reality, we are back to what we do best by blissfully circumventing the best practices. As reported, rampant usage of the anti-biotics has reached an alarming stage drawing the attention of the regulator. Knowing what’s needed to solve a problem is one thing, but doing it is quite another, you see. By now, every doctor in the country should be familiar with the growing antimicrobial resistance and what their role in curbing its spread needs to be, but their prescription behaviour remains largely unreformed. The latest ICMR attempt to reform this behaviour involves advising doctors to avoid using antibiotics in conditions such as low-grade fever and viral bronchitis, plus planning a stop date in advance to ensure antibiotics are not given beyond the recommended duration.
PC: Dr Sunesh
- Unsurprisingly, the costs of using antimicrobial prescriptions for syndrome management rather than based on a definitive diagnosis have been showing up in multiple ICMR studies in recent years. Last year’s data for example indicates that resistance to Imipenem, which is used to treat infections caused by bacteria E Coli, has increased from 14% in 2015 to 36% in 2021. Unfortunately, such resistance is also being fed by the food industry, contaminated soil, and poor sanitation. Thus, doctors and hospitals have a direct role in the matter, and they are being asked for quite a straightforward change in practice.
- This is most welcome. However, the regulator has simply failed to tackle the issue as rigorously as needed. For example, stewardship programmes should by now have spread across hospitals, transparently reporting about both prevalent and targeted levels of antibiotic use. The challenge is of course made worse by how widely chemists stand in for doctors, dishing out antibiotics as blithely as if these were oranges. In conclusion, the regulators need to step up the audits and updation needed to depress antimicrobial resistance on a war footing. Otherwise, the country will be staring at a possible health crisis.
