Antibiotic Misuse and Antimicrobial Stewardship Programmes (AMSP) - Seeker's Thoughts

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Antibiotic Misuse and Antimicrobial Stewardship Programmes (AMSP)

ICMR Guidelines to ensure Judicious Use of Antibiotics in Hospitals
It has released the Antimicrobial Stewardship Guidelines to advice hospitals in setting up Antimicrobial Stewardship Programmes (AMSP) to ensure judicious use of antibiotics in healthcare facilities.

The aim of Guidelines
The aim is to provide guidance in setting up the structure and process of AMSP in hospitals. Therefore basically it would provide tools, and information for AMSP. 
Learning about AMSP
This program is to improve antibiotic uses as in there have been cause of concerns related to the misuse of antibiotics. Inappropriate use of antibiotics is rampant in India for humans and for animal’s productions too.
Antibiotics- There are various diseases which happen due to microbes, bacteria or viruses. Anti-biotic works against these microbes, and these are widely used in treatment and for preventing infections. 

However, the concern occurs when people consume these antibiotics at regular basis. This create where drug does not benefit the health as the body becomes used to, so the pathogens and bacteria.

The Problem

In recent investigations, the world’s largest antibiotic manufacturer – Zoetis has been selling antibiotics as growth promoter to farmers in India, while it has been banned in United States. 

The consumption of these antibiotics has been causing severe damage, and India already has a higher burden of disease. According to a 2016 PLOS Medicine paper, 416 of every 100,000 Indians die of infectious diseases each year. This is more than twice the U.S.’s crude infectious-disease mortality-rate in the 1940s, when antibiotics were first used there.

There are three major sources of resistance:

1-      Overuse of antibiotics by human beings; -To tackle the first source, India classified important antibiotics under Schedule H1 of the Drugs and Cosmetics Rules 1945, so that they couldn’t be sold without prescriptions. Still, Schedule H1 drugs are freely available in pharmacies, with state drug-controllers unable to enforce the law widely

2-    Overuse in the veterinary sector; - As far as veterinary use goes, India’s 2017 National Action Plan on Antimicrobial Resistance did talk about restricting antibiotic use as growth promoters. Sadly, no progress has been made on this front yet, allowing companies to sell last-resort drugs to farmers over the counter.

3-     And environmental antibiotic contamination due to pharmaceutical and hospital discharge- The 2017 document also spoke about regulating antibiotics levels in discharge from pharmaceutical firms. For instance, Hyderabad’s pharmaceutical industry has been pumping massive amounts of antibiotics into local lakes, rivers and sewers. This has led to an explosion in resistance genes in these waterbodies. Still, India is yet to introduce standards for antibiotics in waste water, which means antibiotic discharge in sewage is not even being monitored regularly.

What Should be done?

India needs to strengthen and implement regulations on antibiotic misuse  as antibiotics lose their efficacy against deadly infectious diseases worldwide. The sale of antibiotics should not be considered as usual business for governments, private corporations and individuals who have the power to stall a post-antibiotic apocalypse. The country that stands to lose the most from antibiotic resistance is India, given that its burden of infectious disease is among the world’s highest. If these miracle drugs stop working, no one will be hit harder than India.

This is why the country’s progress towards a tighter regulatory regime must pick up pace. As the country takes its time to formulate regulations, the toll from antibiotic-misuse is growing at an alarming rate. According to a 2013 estimate, around 58,000 newborns die in India each year due to sepsis from resistant bacteria. When these numbers mount, India will have no one to blame but itself.