The superbug challenge

The threat of antibiotic-resistant pathogens is real

The World Health Organization (WHO) recently came out with its maiden list of antibiotic-resistant “priority pathogens”. It does not make a good reading for India since most of the 12 families of bacteria catalogued can be found in the country. The death of a US woman due to such a superbug, or a strain of bacteria immune to all available antibiotics, was a case in point. That death heightened the global disquiet over the growing menace of antibiotics resistance. But India is not alone. Most other countries are witnessing an alarming uptrend in microbial resistance to antibiotics. The WHO has dubbed it as one of the biggest threats to global health. The fear is that the world is heading towards a post-antibiotics era when even common infections and minor injuries might prove fatal for want of cure. What is worse, there is no reliable alternative at hand to antibiotics. Researchers claim to have extracted a new drug from bacteria present in the human nose that has displayed the potential to combat superbugs, but the work is still in a preliminary stage. Besides, there is no guarantee that bacteria will not mutate to develop immunity against the new drug as well.

The WHO maintains that the misuse of antibiotics in humans and farm animals is accelerating the process of resistance development. India, where the abuse of antibiotics is most rampant, is fertile ground for the growth of drug-tolerant bacteria. Remember, the superbug was first detected in 2008 in a Swedish patient of Indian origin who had travelled to this country for medical care. This bug was subsequently named after the Indian capital as New Delhi Metallo-beta-lactamase-1 (NDM-1). Even the intensive care units and operation theatres of reputed hospitals, leave alone government healthcare facilities, have been infested with it. At fault are all the stakeholders in the healthcare sector — patients, doctors and chemists. Patients generally tend to self-medicate with antibiotics even for ailments that do not require these medicines, little realising the long-term impact. Doctors, too, are prone to prescribing relatively more potent antibiotics, even the high-end antibiotics meant for use as the last resort, for minor illnesses. Chemists, undoubtedly, are the biggest culprits as they flout all norms for dispensing antibiotics. They not only sell them without doctors’ prescriptions but also, often, assume the role of healthcare workers themselves to give these drugs to unwary customers. 

Unfortunately, the health authorities and drug regulators, too, are found wanting in preventing microbial immunity from growing to perilous scale. They have been too lax to regulate the manufacture, trade and use of antibiotics. A fairly good policy to tackle antibiotics resistance was formulated way back in 2011 when the enormity of this hazard was realised after the discovery of superbugs in hospitals and urban sewage. However, its implementation has been woefully tardy. As a result, the ban on over-the-counter sale of antibiotics and advisories to doctors to be more circumspect in prescribing these drugs have remained only on paper. It is, therefore, imperative to enforce antibiotics-dispensing norms effectively and also to promote steps for the prevention of common diseases through better hygiene – and, more importantly, vaccination – to obviate the need for using antibiotics.