Antimicrobial resistance high in India, doctors should prescribe antibiotics only if needed: ICMR scientist

By Shalini Bhardwaj
New Delhi [India], September 26 : A study released by the Indian Council of Medical Research (ICMR) has found abuse of antibodies, antivirals or antifungals has increased drug resistance in the country.
According to Dr Kamini Walia, senior scientist, ICMR, OTC drugs taken for diarrhoea like Norflox are not effective against common bugs, and people should avoid taking antibiotics without doctors' advice.
"This report also highlights that routine OTC drugs taken for diarrhoea like Norflox/oflox are not active against common bugs which cause diarrhoea, hence public should refrain from taking antibiotics without doctors' advice," Dr Kamini Walia told ANI. 
She further said that increasing levels of drug resistance hamper the treatment of infections, "increasing levels of resistance hamper our ability to effectively treat infections. ICMR has been publishing these trends for the last six years."
"There is a need to implement good practices for improving diagnostic facilities, improve infection control facilities in hospitals and better education and awareness on the importance of rationalising antibiotic use. Government has taken initiatives to regulate the sale of antimicrobials through H1 schedule and red line campaigns, improve infection control through kayakalp programs etc. and recent focus on antimicrobial stewardship," she added. 
"The next step is to ensure that these programs are effectively implemented to make a real difference in our behaviour towards antimicrobial use both at prescriber and consumer level," she said
The study has covered the Public and Private Hospitals of India, "ICMR AMR network covers hospitals involving full length and breadth of India, both public and private hospitals and only top quality data is collected for annual review," Dr Walia said.
"This year we are happy to report that resistance patterns of major superbugs haven't changed over the last 5-6 years," Dr Walia further said. 
Dr Walia also warned that doctors should avoid prescribing antibiotics if not needed, "However still antimicrobial resistance is very high across India and antibiotic prescription should be taken more seriously by doctors and should only be given to patients only if needed."
This report also gives information about the molecular mechanism of resistance in all superbugs. We found that NDM is very frequently seen in MDR Pseudomonas isolates which is a unique phenomenon seen exclusively in India. This is a very important point for new antibiotic developers as it can help them to tailor new drugs for Indian needs.
"In fungal pathogens, antifungal susceptibility profiling revealed more than 93 per cent
fluconazole susceptibility in C albicans and C tropicalis but declining susceptibility
rates (77 per cent-85 per cent) were reported in C utilis, C parapsilosis and C glabrata thus
requiring close monitoring in the next few years," it added. 
75 per cent of Klebsiella pneumoniae and 88 per cent of Acinetobacter baumannii causing bloodstream infections (BSIs) in ICUs were imipenem resistant. Nearly 87 per cent of Staphylococcus aureus and around 42 per cent of Enterococcus faecium-causing BSIs in ICUs were respectively oxacillin and vancomycin-resistant. Hence, the prevalence of AMR in ICU is very high, so focus on infection control practices in the ICU and other critical areas should be a top priority, the study read.