ICMR releases guidelines to stop antibiotic misuse

NEWDELHI: The Indian Council of Medical Research (ICMR) has released hospital-based antimicrobial stewardship (AMS) guidelines for appropriate use of antibiotics in healthcare settings in India to prevent antibiotic-resistant infections.

The AMS guidelines focus on appropriate drug selection, correct dosing, most effective route of administration, and duration of antimicrobial therapy.

Hospital-acquired superbugs that are extremely resistant to conventional medicines raise the risk of death at least 2.6-fold compared to patients with similar susceptible infections, according to a study published in the journal Clinical Infectious Diseases on Friday.

The death rates in India are much higher than for high-income countries, where death rates are typically less than 7%.

The overall death rate was 13.1% with deaths as high as 29% among patients infected with A. baumannii, the hospital-acquired infection that causes pneumonia, bloodstream infections (bacteraemia and sepsis), meningitis, wound and surgical site infections, including the “flesh-eating” bacterium necrotising fasciitis.

“Antimicrobial Stewardship programs are used globally to encourage judicious use of antibiotics in hospital settings. In recognition of the fact that more hospitals do not have AMS programs, ICMR has issued the guidelines to provide guidance to hospitals to set up structures and processes of AMSP,” said ICMR senior scientist and programme officer ( antimicrobial resistance) Kamini Walia.

“Hospitals with functional AMSP consistently show high susceptibility to antibiotics.”

With very few new antibiotics in the pipeline, it is important to use the existing drugs judiciously. “Antimicrobial resistance will be leading killer, claiming over 10 million lives in the

next three decades.

Antimicrobial Stewardship (AMS) are the most effective interventions to table this crisis,” said Chennai’s Apollo Hospitals infectious disease physician Dr Ramsubramanian V.

“As more people check into hospitals, in part enabled by Ayushman Bharat, it is imperative that we do not let them die because of poor antibiotic use or lack of infection control in health care facilities,” said Washington DC’s Center for Disease Dynamics, Economics & Policy director Ramanan Laxminarayan .

Overuse and misuse of antibiotics in medicine and livestock are driving antibiotic resistance, but poor sanitation, unsafe water, corruption, and low public health also play a role in lowand-middle-income countries, including India, according to a study in Lancet Planetary Health in September.

Global antibiotic use has risen 36% in the decade ending 2010, with Brazil, Russia, India, China, and South Africa accounting for 76% of this surge.

India is the world’s largest consumer of antibiotics, followed by China and the US, according to a study in The Lancet.