Antibiotic Resistance
Antibiotic drug resistance is developed in the micro-organisms. ICMR is
carrying out surveillance of drug resistance to antibiotics through its
Antimicrobial Resistance Surveillance Research Network (AMRSN) in six
pathogenic groups (i) Diarrhoeagenic
bacterial organisms (ii) Enteric fever pathogens (iii) Enterobacteriaceae
causing sepsis (iv) Gram negative Non-fermenters (v)
Gram positives including MRSA (vi) Fungal infections. The data is being
collected from CMC, Vellore, JIPMER, Puducherry,
PGIMER Chandigarh and AIIMS, New Delhi. The significant findings from last 2
years indicate that Salmonella typhi multidrug
resistance (MDR) to ampicillin, chloramphenicol and trimethoprim–sulfamethoxazole
is showing a downward trend. However, more than 50% of bacterial isolates
of Klebsiella spp. and E. coli were
found to be resistant to the currently used 3rd generation cephalosporins, but they are sensitive to carbapenams and colistin. There
is no data available regarding fatalities reported due
to antibiotic resistance.
As informed by ICMR, according to a WHO survey, public health awareness about
antimicrobial resistance is very low. The Government’s Programme
on containment of Antimicrobial
Resistance (AMR) includes the component of increasing awareness on rational use
of antibiotics.
Government of India has signed a Memorandum of Understanding/Agreement for cooperation in
health with several countries. AMR has been identified as one of the areas of
cooperation in Agreements/ MOUS with some of these countries including Sweden,
Netherland and U.K.
During the World Health Assembly in May
2015, the Member States have adopted a Global plan for action on AMR. Further,
Indian Council of Medical Research (ICMR) has signed a Memorandum of Understanding
(MoU) with the Research Council of Norway (RCN), and also
initiated collaboration with National Institute of Health, USA (NIH) and
Centers for Disease Control, Atlanta, USA (CDC) regarding antimicrobial
resistance.
In order to strengthen the surveillance of antimicrobial resistance (AMR)
in the country, Indian Council of Medical Research (ICMR) has set up a National Anti-Microbial Resistance Research and
Surveillance Network (AMRRSN) to enable compilation of National Data of AMR at
different levels of Health Care.
The Drugs and Cosmetic Rule, 1945 were amended in 2013 to incorporate a
new Schedule H1 under the said rules containing 46 drugs which include IIIrd and IVth generation
antibiotics, anti TB drugs and certain habit forming drugs for having strict
control over the sale of these drugs. The Drugs falling under Schedule H1 are
required to be sold in the country with the following conditions:
(1)
The supply of
a drug specified in Schedule H1 shall be recorded in a separate register at the
time of the supply giving the name and address of the prescriber, the name of
the patient, the name of the drug and the quantity supplied and such records
shall be maintained for three years and be open for inspection.
(2)
The drug
specified in Schedule H1 shall be labeled with the symbol Rx which shall be in
red and conspicuously displayed on the left top corner of the label, and shall
also be labeled with the following words in a box with a red border:-
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“Schedule H1 Drug-Warning:
-It is dangerous to take this
preparation except in accordance with the medical advice.
-Not to be sold by retail without the
prescription of a Registered Medical Practitioner.”
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Further, Government of India has formulated a national policy for
containment of antimicrobial resistance in 2011. A National Programme
for Containment of AMR has also been initiated in 12th Five Year Plan with the
following objectives:-
§ To establish a laboratory based surveillance system
by strengthening laboratories for AMR in the country and to generate quality
data on antimicrobial resistance for pathogens of public health importance.
§ To generate awareness among healthcare providers and
in the community regarding rational use of antibiotics.
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