‘The antibiotic pipeline is running dangerously dry’, Pg18

Key Highlights:

• Antimicrobial Resistance (AMR) is a growing public health threat in India, with an estimated 2.67 lakh deaths attributable to it in 2021.
• High resistance rates, treatment gaps, and antibiotic misuse are making common infections untreatable and jeopardizing modern medicine.
• ICMR studies indicate that 1 in 10 patients in India admitted to hospitals with infections are resistant to last-resort antibiotics.
• The antibiotic pipeline is running dry, with few new classes or mechanisms of action being developed.
• Kerala was the first state to launch the antimicrobial stewardship programme in 2015, focusing on rationalizing antibiotic prescription and awareness.

Detailed Insights:

• AMR is a silent pandemic, often dismissed but with a significant impact, as seen during Covid when patients were affected by drug-resistant infections.
• Hospitals, with high antibiotic use, accelerate bacterial resistance through genetic mutations and the transfer of resistance genes.
• Community-acquired infections like typhoid, diarrhoea, and pneumonia are also becoming drug-resistant, contributing to the overall burden of AMR.
• In India, learned behavior of using antibiotics for coughs, colds, or diarrhea contributes to overuse, along with prescriptions for prophylactic use.
• While antibiotic use in livestock and agriculture is a concern, human behavior is a primary driver of resistance to drugs commonly used in humans.
• Antibiotic stewardship programs, like the one in Kerala, are more effective than outright bans on over-the-counter sales, emphasizing responsible antibiotic use.
• Routine infections are becoming harder to treat due to drug-resistant bugs and community-acquired infections becoming complicated by improper antibiotic use.
• Alternative therapies like phage therapy and monoclonal antibodies are being explored to combat AMR, but they are still in early stages of development.

Key Concepts Involved:

• Antimicrobial Resistance (AMR): The ability of microorganisms to resist the effects of antimicrobial drugs, making infections harder to treat.
• Antibiotic Stewardship: Coordinated interventions designed to improve and measure the appropriate use of antibiotics.
• Phage Therapy: Using viruses that infect and kill bacteria to treat bacterial infections.