Growing threat of antimicrobial resistance (AMR) due to antibiotic misuse and pollution

Source: The post growing threat of antimicrobial resistance (AMR) due to antibiotic misuse and pollution has been created, based on the article “What is anti-microbial resistance (AMR) and why is it a grave threat?” published in “Indian Express” on 11th August 2024.

UPSC Syllabus Topic: GS Paper 2 – Issues relating to development and management of Social Sector/Services relating to Health

Context: The article discusses the growing threat of antimicrobial resistance (AMR) due to antibiotic misuse and pollution. It emphasizes the need for better hygiene, vaccinations, proper antibiotic use, and stricter regulations on pharmaceutical waste to prevent drug-resistant infections globally. Ahead of the United Nations conference on September 26, the WHO published its first guidance on antibiotic pollution, emphasizing its global threat.

For detailed information on Antimicrobial Resistance (AMR) in India read Article1, Article2

What is Antimicrobial Resistance (AMR)?

AMR is when a pathogen survives despite the use of antimicrobial drugs. It occurs due to the misuse or overuse of antibiotics. This creates superbugs, which are resistant to medicines. These superbugs spread in hospitals, water, and sewers.

Why is AMR a Concern?

1. AMR makes common infections harder to treat, leading to complications. For example, urinary tract infections now often require hospitalization. In hospitals, AMR leads to longer stays and more expensive treatments.
2. Overuse of antibiotics, like Norfloxacin for diarrhea, has rendered them ineffective.
3. AMR can spread through water, sewers, and hospitals, worsening healthcare outcomes.

Why is AMR Increasing in India?

1. Individuals: Many Indians use antibiotics without medical advice. Antibiotics are used even for viral infections like the flu, which doesn’t need them. This increases resistance.
2. Doctors: Many doctors prescribe broad-spectrum antibiotics unnecessarily. A survey showed that 71.9% of patients in hospitals were given antibiotics, with 55% prescribed not for treatment but for prevention.
3. Pharma Companies: Antibiotic pollution from manufacturing sites contributes to AMR. WHO released guidelines on managing pharmaceutical waste to reduce pollution.

Which Pathogens are Most Resistant in India?

1. E. coli: Resistance to carbapenem, a strong antibiotic, dropped from 81.4% in 2017 to 62.7% in 2023.
2. Klebsiella pneumoniae: Susceptibility to carbapenem medicines reduced from 58.5% to 35.6% and 48% to 37.6% from 2017 to 2023.
3. Acinetobacter baumannii: Its resistance to carbapenems was 88% in 2023, showing a high level of resistance.

What Measures Can Be Taken to Combat AMR?

1. Prevention: Improving hygiene and encouraging vaccinations, like the pneumococcal and flu vaccines, can reduce infections.
2. Education: Doctors should prescribe antibiotics only when necessary and use diagnostic tests to confirm infections.

3.Regulation: Pharmaceutical waste management should be improved to prevent the spread of resistant bacteria from manufacturing facilities.

Question for practice:

Examine the reasons why antimicrobial resistance (AMR) is increasing in India.