[Answered] Evaluate the role of healthcare professionals in exacerbating or controlling the spread of antimicrobial resistance. What measures can be taken to ensure rational prescription of antibiotics?

Antimicrobial resistance occurs when microbes (bacteria, viruses, fungi, and parasites) become resistant to antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics). Healthcare professionals play a crucial role in either exacerbating or controlling the spread of antimicrobial resistance (AMR).

Role of healthcare professionals in controlling or exacerbating the spread of AMR

• Overprescription of Antibiotics: In cases where antibiotics are ineffective, medical practitioners may give antibiotics for viral infections unnecessarily or inappropriately. Antibiotic resistance develops as a result of this behaviour.
• Inadequate Diagnostic Procedures: Before administering antibiotics, medical professionals occasionally neglect to carry out comprehensive diagnostic testing to pinpoint the precise source of an infection. This can result in the prescription of broad-spectrum antibiotics when more appropriate treatment is focused.
• Incomplete Treatment Courses: Patients may not finish the entire course of antibiotics that are given, which could expose bacteria to medicines in part. Resistant strains may survive as a result of this insufficient treatment.
• Lack of Surveillance and Monitoring: There may be inadequate monitoring of antibiotic use and resistance patterns in healthcare settings, making it challenging to identify and address emerging resistance issues promptly.

Measures to ensure rational prescription of antibiotics

• Better Diagnostics: Promoting the use of quick diagnostic tests can assist medical practitioners in more precisely determining the exact source of infections. This decreases the need for needless antibiotic prescriptions and enables targeted treatment.
• Incentives for Responsible Prescribing: Healthcare systems can put in place incentive programs that pay medical practitioners for administering antibiotics appropriately and responsibly. This could be awards, cash incentives, or chances for career advancement.
• International Cooperation: As AMR is a worldwide concern, international cooperation is crucial. To effectively address antibiotic resistance, healthcare professionals and policymakers should collaborate to exchange information, best practices, and resources.
• Regulatory Measures: Governments and regulatory bodies can enforce policies that regulate the sale and distribution of antibiotics. This may include requiring prescriptions for antibiotic medications, limiting over-the-counter availability, and monitoring antibiotic usage in healthcare facilities.

Conclusion

The recent report of the Health Ministry ‘First Multicentric Point Prevalence Survey of Antibiotic Use at 20 NAC-NET Sites India 2021-22’ conducted by the National Centre for Disease Control has made startling observations regarding overprescription of antibiotics in India. It is essential that doctors, government & WHO establish systems that strictly regulate the use of antimicrobials and promote and fund research on newer antibiotics to curb misuse and overuse of antimicrobials.