Public health problems today is the growing antibiotic resistance

One of the world's most pressing public health problems today is the growing antibiotic resistance due to its irrational use over the years. Confirming a bacterial infection, selecting the appropriate antibiotic for the infection and educating patients about the importance of taking therapy as prescribed by physicians are considered critical in treating infectious diseases. 

Bacteria can become resistant in several ways and all of which involve changes in their genetic material or genes. These altered genes enable the bacteria to either destroy the antibiotic or block its ability to inhibit bacterial growth. The laws of natural selection suggest that all bacteria will eventually become resistant to antibiotics at some point. Repeated and improper use of antibiotics are two main causes for increase in resistant bacteria world over. It is estimated that up to 50 per cent of antibiotic prescriptions given in the community settings are not actually needed. 

Patients too contribute to antibiotic resistance by requesting physicians to prescribe antibiotics even if they do not have a bacterial infection. Noncompliance of patients to the antibiotic treatment regimen is another contributory factor for resistance which has become a significant patient safety concern today. In India, scientific debate on antibiotic resistance has taken a serious turn in the wake of a recent controversy over a reference made in the medical journal, Lancet, regarding the superbug called New Delhi metallo-beta-lactamase 1 (NDM-1). 

The superbug is stated to be resistant to the most powerful antibiotics and the circulation of the Lancet report did hit the image of India as a destination for medical tourism and cheaper treatment facilities. Scientific community in the country did take objection to the reference of New Delhi in the name, NDM-1, as it can give a wrong impression that it originated from India. What is, however, more important now is how to bring a control on the antibiotic resistance in the country. 

And it is creditable that the Union health ministry swung into action and set up a task force to review the current situation regarding manufacture, use and misuse of antibiotics in the country and also to initiate studies documenting prescription patterns and establish a monitoring system for the same. The report has been already placed before the Drug Consultative Committee a few weeks ago. Now, DCGI decided to introduce a set of new rules to regulate the sale of antibiotics and add a separate schedule under the Schedule H of the Drugs & Cosmetics Act. 

The new Schedule, HX, is expected to be added to the D&C Act to make it compulsory for patients to carry duplicate prescriptions for buying antibiotics from the chemist shops. One copy of the prescription has to be kept by the chemists for audit up to one year. These are all highly desirable initiatives from the health ministry and not many developing countries have taken such steps to counter this new threat. What is to be seen now is how effectively and fast the health ministry and drug control machinery of the country will be enforcing these critical regulations.