Times
of India
28 October 2010
By Shobha John
New Delhi, India
We all know someone who has popped antibiotics at the first hint of a
sneeze or who hasn’t completed his full course of these medicines. All this
could be a thing of the past as India, for the first time, readies a national
antibiotic policy. It’ll also include the poultry industry and agriculturists.
A policy statement in this regard will be finalized by November.
A 13–member expert panel was constituted by the health ministry in September to
lay down the policy and ways to implement it. While antibiotics can, no doubt,
tackle a severe illness speedily, their indiscriminate use can lead to microbes
becoming resistant to drugs. This can be increasingly seen in tuberculosis,
gonorrhea, malaria and ear infections. According to the Infectious Diseases
Society of America, the cost of antimicrobial resistance to the US health care
system in 1998 was nearly $5 billion. By 2010, this could have increased 10
times.
The need for such a policy in India was felt after the super bug controversy in
March, where researchers reported a new Indian–origin bug, NDM–1, which was resistant
to carbapenem, the strongest antibiotic known. Many developed countries such as
Sweden and UK already have such a policy. In India, Tamil Nadu recently set up
a panel to frame an antibiotics policy.
Components of the policy, accessed by TOI, show a well–thought–out strategy
which will affect doctors, patients, pharmacists, veterinary doctors,
agriculturists and the poultry industry. A task force will be set up in each
state to develop and implement strategies in both the public and private sector.
NGOs too will be involved.
Another component is that drugs and therapeutic committees as well as hospital
infection committees will be set up in all hospitals. A national reference
microbiology laboratory will be set up and will have links with a network of
accredited diagnostic labs.
Further, antibiotics will be classified – for non–restricted, restricted and
very restricted use. There will be a selected list of antibiotics which
shouldn’t be sold in pharmacies without a prescription, such as Ofloxacin which
is used in fevers, says Dr Ranjit Roy Chaudhury, a member of the expert panel.
"Stringent penalties will be imposed if this is violated. Normally,
violators are taken to court but this is a long process; we want something more
drastic," he says. Antibiotics not on the essential drugs list should not
be procured, prescribed or be made available.
Shailendra, a chemist in South Delhi, welcomed this policy, saying it’s a must.
"Often, small–time doctors prescribe antibiotics when there’s no need to.
This overprescription, increases the body’s resistance and more and more
expensive antibiotics are prescribed. If we refuse to sell them, patients,
especially from the lower strata, threaten us. It’s very important to educate
this section of society," he says.
The policy will also make it mandatory to test for the presence of antibiotics
in food items. "Many times, antibiotics are introduced in chicken feed to
make the birds plump. Once injested, they get into our system, increasing
resistance. With this new policy, poultry too will get tested, says Chaudhury.
Honey too has been found to have antibiotics.
Special attention will be paid to make the prices of antibiotics affordable.
Otherwise, patients will stop using them as soon as they feel better without completing
the full course, increasing resistance. Standard treatment guidelines for
antibiotics will be developed. Special insurance programmes too will be
formulated only for reimbursement of antibiotics. This is a pill everyone would
welcome.
Over–prescribed antibiotics
Ciprofloxacin: Used for fever, back pain, TB Augmentin: For sore throat
Ceftriaxone: For Respiratory infection Gentamycin: For urinary infection
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