Antibiotic Use, Misuse – Raise of SUPER-BUGS?

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Antibiotic Use, Misuse – Raise of SUPER-BUGS?

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Antibiotic Use, Misuse – Raise of SUPER-BUGS?

  1. 1. Antibiotic Use, Misuse – Raise of SUPER-BUGS? Dr.T.V.Rao MD Antibioticmisuse isagreatconcern,Microbiologistsworkingwithtrue spiritare the first people toobserve the growingdrugresistance patterns,todaywe have manyK.pneumoniaarising fromchronicallyill patientsandmanyare presentingashospital acquiredinfection,Increasing numberof strainsare resistantto3rd generationcephalosporinsandwe are testingforsensitivity patternsto carbapenemgroupof antibioticsresistance withImipenamandMeropenamisa Universal concern,The fact isthat we are soonapproachinga stage where youas an individualwill knowsomeone whodiedof adrug resistantinfection. Tenyearsagowe didn'treallyhave many issueswithcarbapenemresistance ingramnegativesandnow we have a classof bacteriacalled entro-bacteriapopularizedwithNDMstrainsandwe have verycommoncarbapenemresistance.A sample surveyconductedby the WorldHealthOrganizationinNew Delhi inApril 2011 revealedthat more than half (53%) of Delhi-itessurveyedself-prescribe antibiotics.One infourof those surveyed stoptakingthemonce theyfeltbetter,insteadof finishingthe entire course.Anotherone infour Delhi-ites(25%) treatregularfeverwithantibiotics,and18% of those surveyedre-use antibioticsin the family.Accordingtothe study,16% to 18% physicianssaidtheyprescribeantibioticsfornon- specificfever,cough,andevendiarrhoea.We discussmanymattersinthe Institutional practicesat our Medical colleges,the above saidsurveyshowsmostof the patientsare experimentedwith newergenerationof drugsbefore he comestothe Institutional care,itwill leadtoasituationthat the people are comingtoour Institutionsloadedwithdrugresistance bacteria,Idonot know where our teachingswill standinAntibioticpolicyaswe cannotbe rational and manypatientsare being treatedwithirrational therapiesbefore theyreachthe hospital.PracticallyclinicalMedicineisdying inIndiarapidlyevenfortrivial conditionsultrasoundsandelaborateinvestigationsare done forgettingthattheirclinical will be supportedbydiagnosticprotocols.InRecentinteractionwith Doctors at our hospital everyone hashisownvisiononthe use of Antibiotics,andblame there are no effective MicrobiologyDiagnosticguidanceandfullyagree,inthe Governmentandprivate Medical colleges,have leastinvestmentsare done onMicrobiologyDepartments,asitisnot Income generatingdepartment,Ifeel itistime torealize thatthe mattersare out of control,infuture many patientswithtrivial infectionswill perishwithdrugresistantstrains,We have few optionsother than,implantingandeducatingthe Doctorsonthe National policy,orrationalistantibioticuse,as the national policycouldregulate the overthe countersale,enforce,andregularlykeepatabon stronginfectioncontrol measuresatthe hospitalsacrossthe country.More importantly,itmake pharmacists,doctors,medical professionals,andhealthcare institutionsalikeaccountable forit.It will save livesacrossall age groupsanddemographicsandfrommanydiseases.Until then,itjust remainsIndia’suncomfortable andreal truth.Neverforgetwe are all responsible forthe trendsin change as we thoughtthe magicbulletisthe solution,andbulletmaykill the microbe andmentoo. Major peerreviewedstudiesprove thatmisuse of Antibioticsare attributedto 1 Nexusbetween pharmaceuticalindustryandbusypractitionerswithfreebies,foreigntravelsfor specialistsandsub - specialistscalledasSUPERSPECIALISTS 2 Doctors runningtheirownlaboratoriesandChemistshopsandputtingthe patientstounnecessary investigations 3 Lack of basicknowledge onantibiotics,manytimesguidedbyMedical reps 4 Treatingthe patientswithminimalornoclinical l Diagnosiswithnoideaonwhattheyare treating?
  2. 2. 5 Above all patient’signorance toacceptwhateverthe doctorsare doing 6 Many of the seniormicrobiologistsandProfessorsleavingthe matterstoTechnician’sandjunior facultyleadtoall vagariesinthe Laboratoryscience. If the mattersare notunderstoodandeffective regulationsare notbroughtinpatientsinICU and critical care areaswill be at highestlife threatandevenmanycritical are areasto be closedwith raise of SUPER-BUGS? Dr.T.V.RaoMD Professorof MicrobiologyTravancore Medical CollegeKollam

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