The growing scourge of antimicrobial resistance needs urgent attention
- Ever since the pandemic struck, concerns have been raised about the improper use of antimicrobials amongst Covid-19 patients.
Concern over Antimicrobial resistance
- As per the “Global burden of bacterial antimicrobial resistance (GRAM)” report, 4.95 million people died from drug-resistant bacterial infections in 2019, with 3,89,000 deaths in South Asia alone.
- AMR directly caused at least 1.27 million of those deaths.
- Lower respiratory infections accounted for more than 1.5 million deaths associated with resistance in 2019, making it the most burdensome infectious syndrome.
- Amongst pathogens, E coli was responsible for the most deaths in 2019, followed by K pneumoniae, S aureus, A baumannii, S pneumoniae, and M tuberculosis.
Concern for India
- As per the yearly trends reported by the Indian Council of Medical Research (ICMR)since 2015, India reports a high level of resistance in all these pathogens, especially E coli and K pneumoniae.
- Only a fraction of the Indian data, available through the WHO-GLASS portal, has been included in the GRAM report.
- India has been reporting high levels of resistance to fluoroquinolones, cephalosporins and carbapenems across the Gram-negative pathogens that cause almost 70% of infections in communities and hospitals.
- Therefore, the Indian data on the AMR burden may not look very different from the estimates published in the report.
- With no new drugs in the pipeline for drug-resistant infections, time is running out for patients.
Multipronged and multisectoral approach
- Use existing antimicrobials judiciously: The urgency to develop new drugs should not discourage us from instituting measures to use the existing antimicrobials judiciously.
- Improved infection control in communities and hospitals, availability and utilisation of quality diagnostics and laboratories and educating people about antimicrobials have proved effective in reducing antimicrobial pressure — a precursor to resistance.
- The National Action Plan for AMR, approved in 2017, completes its official duration this year.
- The progress under the plan has been far from satisfactory.
- There is enough evidence that interventions like infection control, improved diagnosis and antimicrobial stewardship are effective in the containment of AMR.
Conclusion
- The GRAM report has underlined that postponing action could prove costly"