The widespread and indiscriminate use of antibiotics in India has probably helped in making the superbug NDM1 (New Delhi metallo-beta-lactamase-1) resistant to virtually every known antibiotic. The defensive attitude taken by the medical profession in India when the Lancet report was first published is less apparent now and the Government has been forced to address the issue of the use of antibiotics.
image:jetlib.com
Three cases have been found in the US. Three people returned to the US from India earlier this year infected with the newly described “superbugs” that are highly resistant to antibiotics, according to media reports. All three confirmed cases – one each in California, Illinois and Massachusetts – involved people who got medical care in India. The Illinois patient recovered, and there is no evidence the infection was transmitted to other people. Another person was treated at Massachusetts General Hospital and isolated, a measure that prevented the germ from spreading, said David Hooper, chief of the hospital’s infection control unit, the Boston Herald said. The Massachusetts patient too survived. The daily said the superbug seems to have been contained. All three patients developed urinary tract infections that carried a genetic feature that made their cases harder to treat.
Taiwan on Thursday decided to declare it a category-four communicable disease. According to Taiwan’s Centre for Disease Control, NDM-1 has the potential to become a serious public health problem as the superbug is extremely virulent and resistant to almost all antibiotics, even the most powerful ones.
Sify comments that:
The Government of India has constituted a committee to formulate a policy for the rational use of antibiotics. The 13-member task force, chaired by the Director-General of Health Services, is expected to submit a report within two months.
The task ahead is Herculean, because it requires a change of culture both on the part of doctors and patients. In a country where a significant portion of the people cannot afford most useful medicines, doctors routinely over-prescribe antibiotics to those who consult them. What is worse, patients are often dissatisfied with a doctor who may advise that, say, a viral infection should be roughed out if it does not get serious and not be pointlessly treated with antibiotics. This is, of course, just a little better than in China where many patients are not satisfied unless a doctor prescribes an injectable. Poor and uninformed patients in India also routinely use an older prescription to treat a new ailment whose symptoms appear similar, and then do not complete a course once undertaken. Further, although antibiotics are to be sold only against prescriptions, chemists routinely sell them over the counter, acting as makeshift doctors in response to patients’ narration of symptoms and request for some tablets.
It is also necessary to examine what can be done to counter the depredations (there is no other word for it) of drug companies and their armies of medical representatives at whose request most doctors do their prescribing. The best long-term weapon is right public awareness on these issues. Civil society has a larger role to play in this regard than government.
The k2p blog 