Most hospitals in India do not follow processes to prevent anti-microbial resistance (AMR), according to the Indian Council of Medical Research (ICMR).
AMR is defined as resistance of a microorganism to an antimicrobial drug that was originally effective for treatment of infections caused by it.
Such treatment failures also lead to longer periods of infectivity, increasing the number of infected people in the community.
“This in turn exposes the general population to the risk of contracting a resistant strain of microorganisms. As they become resistant to first-line antimicrobials, the forbidding high cost of the second-line drugs may result in failure to treat these diseases,” according to a new set of guidelines released by the ICMR for hospitals.
The guidelines include detailed instructions on drug selection, dosage and duration for anti-microbial drugs, especially inside ICUS. Hospitals can also refer to it for processes related to disposing off antibiotics that have not been used, said an ICMR spokesperson.
A big reason for the rise of antimicrobial resistance (AMR) is the inappropriate use of antibiotics, which is rampant in India.
A recent report by the Centre for Disease Dynamics, Economics and Policy, suggests that over 50,000 children die in India due to antibiotic resistant infections.
Very few new antibiotics are in the pipeline, and hence it is important to use the existing drugs judiciously, ICMR experts say.
In one of the largest studies to measure the burden of antibiotic resistance in a low- or middle-income country, the CDDEP found that in-hospital deaths were significantly higher among patients infected with MDR (multi-drug resistant) or XDR (extensively drug resistant) pathogens including Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii.
The overall mortality rate among all study participants was 13.1 per cent, with mortality as high as 29.0 per cent among patients infected with A. baumannii. Patients who died were more likely to have been older and admitted to the intensive care unit (ICU) at the time of testing, said the CDDEP report.
“There is an urgent need to improve antibiotic use in hospitals, which can be achieved through implementation of good Anti-microbial Stewardship Programs (described in the guidelines). AMS Programmess have been found helpful in improving the quality of patient care and safety through increasing the frequency of correct prescribing for therapy and prophylaxis, reducing treatment failures and increased infection cure rates as most of hospitals in India lack structure and process of AMSP,” an ICMR statement on the guidelines said.
Such programmes are widely followed in developed countries, the ICMR spokesperson said, adding that the institute was engaged in training hospital administrators in the programme.