Antimicrobial Resistance (AMR) is a serious condition caused by organisms such as bacteria, viruses, fungi, and parasites. Patients with this type of condition can no longer respond to the usual medications. They may require highly broad-spectrum, multiple, and at times toxic medicines for an extended period for treatment. In worst cases, some of these organisms may not react to any otherwise effective antimicrobial drug, leading to bad outcomes.
In an exclusive interaction with OnlyMyHealth editorial team, Dr Sanjith Saseedharan, Consultant & Head Critical Care, SL Raheja Hospital, Mahim-A Fortis Associate explains what is antimicrobial resistance and how it impacts human health. Here is what he shared with us.
It is known that there is a steady increase in antimicrobial resistance, by about 5-10% every year, and it does not seem to get better. This is a significant health problem and an economic burden on individuals. India is known to be the world's ‘Antimicrobial Resistance capital’, and there are many reasons why antimicrobial resistance seems to be on an alarming rise.
The unscrupulous, unmonitored, excessive, and often unindicated use of antibiotics by unspecialized workers and the common public have resulted in this issue. Here is a small example of the common cold - a virus causes almost 95% of the common cold. However, the average common person would visit a local medical store and ask for Azithromycin. Now Azithromycin is an antibiotic, and antibiotics treat bacterial infections, whereas 95% of the time, a common cold is a viral problem that is self-limiting and requires just symptomatic management like decongestants and cough syrups. Such unindicated use with easy availability of drugs over the counter (OTC) is responsible for increased antimicrobial resistance.
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Another important reason for the increase in antimicrobial resistance is the excessive use of livestock and domesticated animals to improve productivity and prevent diseases in them. Wastewater is another source of the problem; pharmaceutical wastewater & non-optimally treated hospital wastewater contains multiple antibiotic effluents. These would naturally be present in patients' secretion; unused antibiotic containers having antibiotics, body fluids, and other sources of small quantities of antimicrobials and resistant organisms are other sources of the problem. Importantly many antimicrobials (especially the ones non-indicated) are excreted unchanged via human faeces and urine, thus contributing to sublethal doses of antibiotics in the wastewater. Microorganisms exposed to these doses develop resistance and therefore enter the groundwater if not treated well, leading to increasing resistance patterns. Even using multiple biocides like pesticides, fertilizers, and insecticides would change the soil bacteria and thus contribute to antimicrobial resistance.
Doctors, especially those working in hospitals and Intensive Care Units (ICU), come across many patients demonstrating inadequate responses to existing antibiotics and, thus, a poor response to treatment. This has naturally required the doctors to resort to more potent antibiotics (which come with their side effect profile) that would have otherwise not been used. Moreover, with not many new antibiotics in the pipeline, doctors are left with significantly fewer choices in the treatment of resistant organisms leading to poor outcomes, prolonged treatment duration, and even increased death rates. Very soon, we will be in the antimicrobial resistance "pandemic", where the ordinary public will succumb to seemingly simple infections because of the lack of a sensitive, effective antibiotic.
In conclusion, many steps are being taken nationally and internationally to combat this menace. At the same time, it is essential to take more drastic and practical measures to halt the progress of antimicrobial resistance.
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