Pan-drug resistant bacteria on
the rise in hospital ICUs
Antibiotic resistance is a mounting concern
in hospital settings and prolongs infections
New Delhi, 15 November 2017: Recent statistics indicate that about 7-8%
of patients admitted in the intensive care units (ICU) are infected with
pan-drug resistant bacteria.[1] It becomes very difficult to destroy these
bacteria with existing antibiotics. As a result, infections persist for a
longer duration and the treatment is also harder and more expensive. Infections
that are not sensitive to any antibiotics require to be treated with a cocktail
of antibiotics belonging to different categories.
Antibiotic resistance falls under three
categories: Multidrug resistance (MDR), extensively-drug resistance (XDR) and
pan-drug resistance (PDR). Of these, pan resistance is the toughest to treat.
This is followed by XDR infections, which do not show a response to at least
one drug in all but two or less antimicrobial categories. MDR infections do not
respond to at least one drug in three or more antimicrobial drug categories.
PDR bacteria do not respond to any drug in all antimicrobial categories. The
incidence of infections falling under the pan resistance category is seeing a
rise.
Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President
Indian Medical Association (IMA) and President Heart Care Foundation of India
(HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “People reach a tertiary care center only after they
have consumed antibiotics prescribed by numerous other hospitals. There are
very few new antibiotics in the pipeline. Last year, a new antibiotic called ‘teixobactin’
was discovered. It is the first antibiotic to be discovered in three decades
and is still in at an early stage of development.
Options are running out now with a lot of hard work required to protect the
efficacy of existing antibiotics. There is a need to ensure that they are used
only when necessary. Every hospital should also have an antibiotic policy for
all its ICUs depending on the resistance pattern determined by the microbiology
department.”
The WHO has recognized antibiotic resistance
as a significant public health problem in its first global report released in
2014. Further, it indicates that no age group is exempt from antibiotic
resistance.
Adding further, Dr Aggarwal, said,
“Patients often demand antibiotics even when the doctor thinks it is
unnecessary. Antibiotic consent should be a part of the informed consent
process so that the patient is aware of the benefits and risks of antibiotics.
If you have prescribed antibiotics, put the name of the antibiotic in a box
underline it so that patient can identify the antibiotic in the prescription.
Write the total number of antibiotic tablets capsules to be taken for the
prescribed duration in the prescription and not just the dose administration
schedule.”
Some tips to prevent antibiotic resistance
include the following.
- Take antibiotics exactly as prescribed and avoid skipping doses.
- Complete the prescribed course of treatment, even when you start feeling better.
- Do not share or use leftover antibiotics. Antibiotics are meant to treat specific types of infections. Taking the wrong medicine may delay treatment and allow bacteria to multiply.
- Discard any leftover medication once the prescribed course of treatment is completed and do not reuse them if you fall sick again.
- Do not ask for antibiotics if the doctor says you do not need them. Antibiotics have side effects.
- Prevent infections by practicing good hand hygiene and getting recommended vaccines.
