New Delhi: The health ministry has formed a committee to frame a policy for antibiotic use, following an uproar over a Lancet study that traced a drug-resistant bacterial superbug’s origins to India.
The appointment of the panel is also belated recognition that the government has finally been pushed into doing something to check the excessive use of antibiotics among Indians that has led to the growing inability of doctors to curb outbreaks because disease-causing organisms have developed resistance to the drugs.
Much of this is because people are prescribing medicines for themselves.
“There is a lot of self-medication that is practised by people here and that can lead to drug resistance. This needs to be checked,” said health secretary K. Sujatha Rao. “It is important to have a national policy for antibiotic use in India.”
The panel, formed a week ago, is headed by director general of health services R.K. Srivastava, and is supposed to prepare a draft of the policy in the next six weeks.
While hospitals in India already have their own policies regarding antibiotics, there is no common standard across the country.
The 11 August issue of the Lancet Infectious Diseases Journal published a report that linked a drug-resistant superbug to India. According to the report, the superbug can cause multiple organ failure and has even been named after the Capital city NDM-1 (New Delhi metallo-beta-lactamase).
While the Indian government rejected the findings of the report, claiming that such bacteria can be found anywhere, it has taken note of the lack of a policy on antibiotics, and control and mapping of hospital-acquired infections.
Drug-resistant strains often develop when a particular drug is either overused by a patient or underused. While in India all antibiotics are prescription-based, most are sold over the counter since they are used to treat common bacterial infections.
“The idea is to look at major things, which will make the antibiotic level drop in the country. So, we will look into rational use of drugs, making surveillance compulsory, making pharmacy audits compulsory, and look at the regulatory pathway for humans and animals with regard to antibiotics,” said N.K. Ganguly, adviser to the health ministry and member of the committee preparing the antibiotic policy.
Some experts believe any policy will fail at the implementation level.
“The problem with this policy lies at two levels—the prescribing level and the patient level. First, you have to educate the doctor who is prescribing it. We have studied prescribing habits and found that between 50-80% doctors across the country prescribe the wrong medicine. And if you go with the same symptoms to three different doctors, all three will prescribe different medicines,” said C.M. Gulhati, editor of medical journal Monthly Index of Medical Specialities. “The second problem is that patients tend to follow a previous prescription in similar symptoms because they don’t want to spend money on doctor consultation. A prescription is more expensive than the antibiotic, so they just go and buy the antibiotic from the store.”
With a lack of treatment or prescription guidelines, and with rampant self-medication, resistance to antibiotics is a common feature in India. Moreover, once symptoms start to fade, patients often stop an antibiotic treatment halfway, creating an environment for the development of drug-resistant strains of the bacteria.