New Delhi: Being aware of the fact that antimicrobial resistance (AMR) is becoming a major health threat in India and across the globe, the director general of health service (DGHS) has proposed the constitution of a hospital pre-authorisation committee and implementation of audit on antibiotic usage under institutional antimicrobial stewardship programme.
Giving a direction to the States and Union Territories, DGHS Dr Atul Goel said that the committee would be responsible for reviewing and approving requests for the use of specific antibiotics, ensuring that their usage aligns with established guidelines and is justified based on clinical need.
“The committee may comprise various domain experts from clinical specialities, microbiology and pharmacology etc,” the letter in possession of ETV Bharat said. The committee will ensure judicious use of antibiotics, particularly watch and reserve category antibiotics, it mentioned.
It is worth mentioning that AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death. Its emergence and spread is accelerated by human activity, mainly the misuse and overuse of antimicrobials to treat, prevent or control infections in humans, animals and plants.
India is one of the major contributors to global AMR due to extensive antibiotic abuse. In 2021, India alone reported 100,000 cases of antibiotic-resistant mostly among infants, the elderly, and those with comorbidities. Dr Goel, in his letter, said that AMR is a global health threat that requires exigent and concerted action to mitigate its impact.
He said that one of the key drivers of AMR is the irrational use of antibiotics, including inappropriate prescribing practices and misuse of watch and particularly reserve category antibiotics. “To address this pressing issue and uphold our commitment to patient safety and quality of care, it is imperative that we establish a robust mechanism for monitoring and regulating antibiotic usage within our medical institution,” Dr Goel said.
According to the World Health Organisation (WHO), AMR led to the death of close to 5 million people globally in 2019; and if no action is taken, AMR could cost the world’s economy a lump sum US $100 trillion by 2050.
Referring to the implementation of an audit on antibiotic usage, Dr Goel said, “We must conduct regular audits to evaluate the patterns and trends of prescribing antibiotic and usage within our institutions. This audit will provide valuable insights into prescribing practices, identify areas of improvement, and enable us to track progress in our antimicrobial stewardship efforts.”
He said that the antibiotics under strict stewardship may be based on various criteria like broad spectrum usage, newer agents, drugs subject to misuse, antibiotics with a high incidence of adverse reaction.
“By implementing these measures, we may be able to combat the menace of emergence of antimicrobial resistance and promote responsible antibiotic use within our institutions. Additionally, these efforts will contribute to improving patient outcomes, reducing incidence of adverse drug reactions, and preserving the effectiveness of antibiotics for future generations,” Dr Goel said.
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