Eat­ing chicken is like tak­ing a course of an­tibi­otics'

Down to Earth - - COVER STORY -

Devi Shetty, car­diac sur­geon and founder of Narayana Health, has seen in­creas­ing cases of an­tibi­otic re­sis­tance at his hos­pi­tal. Even those who had never taken an­tibi­otics are re­port­ing it. Edited ex­cerpts from an in­ter­view

How does an­tibi­otic re­sis­tance af­fect treat­ment of pa­tients?

We are es­sen­tially go­ing back to the pre-peni­cillin era. Dur­ing the World Wars, sol­diers used to suc­cumb to even mi­nor in­juries be­cause there were no effective an­tibi­otics. To­day, a plenty of an­tibi­otics are avail­able but a ma­jor­ity are not effective be­cause bac­te­ria have de­vel­oped re­sis­tance to­wards them. This is a ma­jor cri­sis that is go­ing to hit the health sec­tor. We may do fancy op­er­a­tions and life-sav­ing pro­ce­dures on the heart and brain. Peo­ple may sus­tain mi­nor bruises and in­juries. But all of them can die due to an in­fec­tion by a bac­te­ria that is re­sis­tant to an­tibi­otics. Ev­ery coun­try is vul­ner­a­ble to this prob­lem, which is go­ing to strike the world in near future.

For­tu­nately, or un­for­tu­nately, wealthy coun­tries are more vul­ner­a­ble than poor coun­tries, be­cause they are the ones abus­ing the an­tibi­otics.

What is the ex­tent and sever­ity of the prob­lem?

It is a ma­jor cri­sis. To­day if you go to any hos­pi­tal, a sig­nif­i­cant per­cent­age of their pa­tients suf­fer from multi-drug re­sis­tant bac­te­ria. The worst thing is, it is not the pa­tient who was hos­pi­talised for a long time, or who has gone from one hos­pi­tal to the other, ac­quir­ing var­i­ous multi-drug re­sis­tant bac­te­ria. It is the pa­tient who walks from vil­lages that are rel­a­tively clean, and is com­ing to hos­pi­tal for the first time who is with re­sis­tant bac­te­ria, even be­fore the treat­ment.

What do you think has trig­gered its emer­gence and spread?

The spread is be­cause our ev­ery­day food is con­tam­i­nated with an­tibi­otics. When we eat chicken, it is like tak­ing a course of an­tibi­otics. Fish and honey also con­tain an­tibi­otics. Vir­tu­ally all food has an­tibi­otics. This was the case in Western coun­tries. They took mea­sures to con­trol it. We need to do the same.

Does the ex­ist­ing sci­en­tific knowl­edge es­tab­lish the con­nec­tion between an­tibi­otic re­sis­tance and food?

If we find bac­te­ria like ESBL in the gut of some­body who has never stepped into a hos­pi­tal nor taken an­tibi­otics, then there is only one source of bac­te­ria they could have got it from, and that is from the food. I can't think of any other source which could have given them enough an­tibi­otics to pro­duce re­sis­tance.

What should the gov­ern­ment and the in­dus­try do to re­spond to this in­crease in re­sis­tance?

First of all, we do not have to rein­vent the wheel. All we have to do is fol­low what Europe has done. There are stan­dard pro­to­cols in many parts of the world about an­tibi­otic us­age in poul­try farm­ing. The pro­to­cols en­sure that there is no trace of an­tibi­otic when hu­mans con­sume this food. We just have to im­ple­ment it in our coun­try.

So, where do you think is the hur­dle?

There is re­ally no hur­dle. It is just that the gov­ern­ment needs data and this data should come from a re­spon­si­ble body like CSE. When the gov­ern­ment ap­proaches the in­dus­try with reg­u­la­tions, the in­dus­try will be un­happy to some ex­tent. They have one way of func­tion­ing, and reg­u­la­tions are go­ing to dis­rupt that. But in the long term they will ob­vi­ously be happy.

Now, the gov­ern­ment should be em­pow­ered with data from In­dia. Be­fore this study, there was no such data. The data will clearly show the mag­ni­tude of the prob­lem of food con­tam­i­na­tion with an­tibi­otics. Now the gov­ern­ment can safely face the in­dus­try and say that we have the data to prove that this is the amount of an­tibi­otics that is present in chicken or fish or honey. This will help the gov­ern­ment take ac­tion.

What more can be done?

Cit­i­zens should be ed­u­cated about what they are eat­ing, what does their food con­tain, and what are the con­se­quences. Be­cause ul­ti­mately changes don't hap­pen by the gov­ern­ment or the pol­icy mak­ers. They are brought out by the cit­i­zens. So we should make ev­ery ef­fort to ed­u­cate peo­ple about the con­se­quences of an­tibi­otic abuse.

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