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Indian Medical Association to educate doctors on judicious use of antibiotics

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The Indian Medical Association (IMA), the umbrella body of allopathy doctors, is starting a campaign on judicious use of antibiotics. Through this it aims to educate doctors, as it has been found that many doctors don't prescribe antibiotics rationally, leading to people developing resistance to antibiotics.

The decision comes soon after the US Centre for Disease Control and Prevention ranked antibiotics resistance in the categories: urgent, serious, and concerning.

Dr Jayant Lele, general secretary, IMA Maharashtra, said: "The decision was taken in a recent meeting at the IMA headquarter in Rajasthan. We plan to educate our doctors on the rationale use of antibiotics (while prescribing)."

"We will start the campaign in a week. Our magazine will have articles on usage of antibiotic usage. We will be sending letters to our members too," said Dr Lele.

According to him, emphasis will be on following international standards in prescribing antibiotics. "The dosage and duration of antibiotics should be properly explained to the patient while prescribing it. It's important for the patient to be educated on why s/he should complete the course and what resistance to antibiotic means. It's a known fact that many patients discontinue the medicine once they feel better," said Dr Lele.

On judicious use of antibiotics, Dr Lele said: "It has been observed that many doctors routinely prescribe antibiotics even for viral fever or nasal cold. This needs to be avoided. Doctor should be able to justify why they are prescribing antibiotics," he said.

Appreciating IMA's effort, Dr Pravin Amin, intensivist, Bombay hospital said: "The antibiotic-resistance problem is worse here compared to West. In the last few years, we have seen a rapid rise in antibiotic-resistance. Bacterias that showed 90% sensitivity to antibiotics are now showing 20-30% sensitivity."

Antibiotic-resistance is the resistance shown by bacteria such as E Coli, which causes gastroenteritis or urinary tract infections, to a drug to which it was originally sensitive.

Giving an example of the superbug, New Delhi Metallo-B-Lactamose 1 (NDM1), Dr Khusrav Bajan, consultant intensivist, PD Hinduja Hospital, said that no new groups of antibiotics had been developed since the 1990s. "Microorganisms have evolved at a higher rate than drugs being developed to counter them. The current high-end antibiotics have become ineffective in treating some infections. NDM1 is just one example. Carbapenem is the last group of antibiotics developed worldwide."

According to experts, anti-microbial resistance is the result of inappropriate use of antibiotics as a result of doctors not being judicious in prescribing them, widespread over-the-counter sales and patients failing to complete the course.

Antimicrobial/antibiotic resistance
Antimicrobial resistance or drug resistance occurs when microorganisms—bacteria, viruses, fungi and parasites—change in ways that render the medications used to cure infections they cause ineffective.

When microorganisms become resistant to most anti-microbials they are often referred to as "superbugs". This is a major concern because an infection that is resistant to drugs may kill, can spread to others, and imposes huge costs on individuals/society.

Why it's a global concern
AMR hampers control of infectious diseases.
Reduces effectiveness of treatment and patient remains infected for longer period with potential to spread resistant microorganisms to others.
Increases costs of health care.
Threatens a return to pre-antibiotic era.
Key facts on AMR (from WHO site)
Infections caused by resistant microorganisms often fail to respond to conventional treatment, resulting in prolonged illness and greater risk of death.

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