While the world is yet to emerge from one pandemic, one staring in the face is that of antimicrobial resistance. Over the past few decades, many life-saving antibiotics have become ineffective as disease-causing microbes have developed resistance to them, making it difficult for physicians to treat many infections. In India, self-prescription and over prescription are just part of the problems.
In the offing is a much-needed study by the Global Antibiotic Research and Development Partnership (GARDP), and the Indian Council of Medical Research (ICMR) that will help us understand drug-resistant infections and treat patients better in the future.
Research published in The Lancet shows that nearly 1.3 million people – and potentially millions more – died as a direct cause of antibiotic-resistant infections in 2019. Countries in South Asia and sub-Saharan Africa are the hardest hit by the impact of antimicrobial resistance.
The proposed study will collect and analyze data in 180 patients receiving treatment for infections caused by organisms resistant to carbapenems – last-line antibiotics that are typically used to treat hospital-acquired infections – across six leading hospitals in India.
“We are seeing rising rates of resistance to carbapenems,” said Francois Franceschi, GARDP’s Project Lead for Serious Bacterial Infections. “This study is designed to give us some of the answers we need to provide better treatments for people who develop these deadly antibiotic-resistant infections.”
Called SBI-CREP-01, the observational study will look at epidemiology as well as treatments administered to both adults and children with severe bacterial infections caused by carbapenem-resistant Enterobacterales (CRE) and/or Pseudomonas aeruginosa (CRPA). Infections caused by these bacteria are difficult to treat because they do not respond to commonly used last-line antibiotics.
The researchers will also collect data on the clinical outcomes for patients with confirmed CRE/CRPA infections in the six hospital sites.
The Indian Priority Pathogen List, which guides research, discovery, and development of new antibiotics in India, has recognized these infections as critical.
“Treating Pseudomonas infections has become significantly more difficult because of antibiotic resistance. Without enough antibiotics in the pipeline to address this challenge and as access to newer drugs is not available in India, the situation appears grim. More research as well as active involvement of regulators and policymakers is vital. The study will provide crucial information that could ultimately be used to improve treatments and help reduce deaths and illness associated with bacterial infections,” said Dr Soumyadip Chatterjee, principal investigator for the SBI-CREP-01 study at the Department of Infectious Diseases, Tata Medical Centre, Kolkata, India.
Moreover, the study findings will prepare these hospitals to conduct future interventional trials of novel therapeutics that can combat carbapenem-resistant infections.
GARDP’s observational study is also underway at five hospitals in South Africa. In India, it is collaborating with the ICMR to conduct the observational study at Kasturba Medical College in Manipal, Christian Medical College in Vellore, Tata Medical Centre in Kolkata, P.D. Hinduja Hospital & Medical Research Centre in Mumbai, the Postgraduate Institute of Medical Education and Research (PGIMER) in Chandigarh and Sir Ganga Ram Hospital in New Delhi.