Q. Critically analyze the implications of antibiotic overuse in India and its contribution to antimicrobial resistance (AMR). What are the measures that should be taken by the healthcare system and policy makers to address this challenge? (15 marks, 250 words)

Answer:

Approach:

  • Introduction: Highlight the critical issue of antibiotic overuse in India and its contribution to the growing problem of antimicrobial resistance (AMR).
  • Body: 
    • Detail the consequences of AMR on public health, healthcare delivery, and economic costs.
    • Outline the steps taken by the Indian government and healthcare authorities.
  • Conclusion: Emphasize the importance of a comprehensive and proactive approach to address AMR, involving coordinated efforts from healthcare systems, policymakers, and public awareness.

 

Introduction:

Antibiotic overuse in India poses a significant challenge, exacerbating the issue of antimicrobial resistance (AMR). This critical issue affects not only the healthcare system but also public health at large.

Body:

Implications of Antibiotic Overuse:

Antibiotic overuse leads to the emergence and rapid spread of AMR, threatening public health globally and particularly in India. This crisis affects the effective treatment of infectious diseases, increases mortality rates, lengthens hospital stays, and escalates healthcare costs. AMR risks a return to the pre-antibiotic era, where common infections and minor surgeries could again become life-threatening​​.

Measures by Healthcare System and Policymakers:

  • National Program on AMR Containment: Launched in 2012-17, strengthening the AMR Surveillance Network with labs in State Medical Colleges.
  • National Action Plan on AMR (NAP-AMR): Launched in 2017, focusing on a One Health approach involving various stakeholders. States like Kerala, Madhya Pradesh, and Delhi have launched their action plans.
  • AMR Surveillance and Research Network: Established by ICMR in 2013, comprising 30 tertiary care hospitals to track drug-resistant infections.
  • AMR Research and International Collaboration: ICMR’s initiatives with international collaborations to develop new drugs and strengthen medical research in AMR.
  • Antibiotic Stewardship Program (AMSP): ICMR initiated this program in 20 tertiary care hospitals to control antibiotic misuse and overuse.
  • Banning Inappropriate Antibiotics: DCGI, on ICMR’s recommendation, banned 40 fixed dose combinations found inappropriate.
  • Colistin Ban in Animal Feed: ICMR, along with other agencies, banned the use of Colistin as a growth promoter in animal feed in poultry​​.
  • National Guidelines for Infection Prevention and Control: Released by MoHFW in 2020, focusing on rationalizing antibiotic usage and establishing consistency in treating infectious conditions.
  • Treatment Guidelines for Antimicrobial Use in Common Syndromes: Issued by ICMR in 2019 to standardize the treatment of various infectious diseases​​.
  • Public Awareness Campaigns: Development of media material to educate stakeholders about AMR and the appropriate use of antibiotics​​.

Conclusion:

The challenge posed by antibiotic overuse and the resultant AMR in India necessitates a coordinated and multifaceted approach. The healthcare system and policymakers have implemented several measures, but continued vigilance and proactive strategies are essential. Strengthening surveillance, research, public awareness, and international collaboration are critical to curbing the tide of AMR. This approach not only safeguards public health but also supports the sustainability of healthcare systems and the effectiveness of antibiotics for future generations.

 

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UDAAN PRELIMS WALLAH
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