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Ramesh Shankar
Wednesday, November 23, 2022, 08:00 Hrs  [IST]

The issue of Antimicrobial Resistance (AMR) has been hitting the headlines for the last some years in the country as it has become a serious and growing public health issue that threatens the effective prevention and treatment of an increasing range of bacterial infections. Like in India, AMR has been identified as a global health threat with serious health, political and economic implications. The emergence of resistance is not only limited to the older and more frequently used classes of drugs but there has also been a rapid increase in resistance to the newer and more expensive drugs like carbapenems. Available data indicates to rising rates of AMR across multiple pathogens of clinical importance, at the national scale. It is true that the Indian government has taken a series of measures to address this issue during the last some years. But the fact remains that the issue is far from over. Regulatory intervention is urgently required for a complete ban of over-the-counter (OTC) sale of antibiotics which is a pathway for the rapid emergence of the antimicrobial resistance. OTC sale of antibiotics which kill microorganisms or reduce the presence of microbes leads to their misuse or overuse. Sale of antibiotics without a valid prescription from a qualified doctor has to be prohibited with immediate effect. In fact, the National Health Policy 2017, issued by the Union Health Ministry, had highlighted the problem of antimicrobial resistance and called for a rapid standardization of guidelines regarding antibiotic use, limiting the use of antibiotics as OTC medications, banning or restricting the use of antibiotics as growth promoters in animal livestock.

In such a backdrop, the launch of a national program to promote rational use of antibiotics by the Apollo Hospitals, one of Asia's biggest integrated healthcare services providers, deserves kudos. Apollo has recently launched an Antimicrobial Stewardship Programme which will sensitize care providers on AMR and it will aim to optimize the use of antibiotics, turn the tide on AMR, and ensure continued effective treatment of infections for future generations. Regular audits and benchmarking of best practices, surveillance and monitoring of metrics for antibiotic consumption and the patient outcome will form an integral part of this program. It will be the largest program of its kind in the country to promote the rational use of antibiotics to combat the rising burden of AMR, also known as drug resistance in the community. It will support the government of India’s National Action Plan on the containment of Antimicrobial Resistance (NAP-AMR) and ICMR’s AMR Surveillance and Research Network (AMRSN) to control AMR by empowering doctors to use antibiotics judiciously. Apollo has launched this program as its data of over three lakhs bacterial isolates since 2019 across 20 different locations in India has shown a considerable increase in community-acquired antimicrobial resistance which warranted immediate measures to stop this emerging trend. It is a fact that since the discovery of Penicillin in 1928, antibiotics have significantly improved global health. They have been a cornerstone of modern medicine, including cancer chemotherapy and advanced surgical procedures. But decades of overuse and misuse of antibiotics have accelerated the emergence and spread of resistant microbes. Infections caused by drug-resistant organisms lead to prolonged duration of hospitalization and increased mortality, causing a huge financial burden to the affected persons, and healthcare systems, and hindering the goals of sustainable development. Antibiotic resistance has led to the emergence of multi-drug resistant (MDR) and extensively drug-resistant (XDR) strains of mycobacterium tuberculosis, the bacteria that is responsible for tuberculosis. The issue is very serious. The country, for that matter the entire world, today is literally standing on the edge of a post-antibiotic era - a world without antibiotics, in which illnesses from minor throat infections to serious illnesses like cholera, tuberculosis, pneumonia, etc are untreatable. Under this background, Apollo’s latest initiative is exemplary.


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