When it comes to antibiotics, an over 10% resistance is almost too high.
Indians show resistance as high as 99.9% towards some antibiotics. This, as per a paper published in the Indian Journal of Medical Research (IJMR) on 3 June—the first paper that indisputably establishes that Indians are alarmingly antibiotic resistant. Not only are Indians resistant to older antibiotics like penicillin by over 90%, the resistance to newer antibiotics like ciprofloxacin is also over 40%. The World Health Organisation (WHO) classifies antibiotics into three categories—access, watch and reserve, with each category stronger than the last.
In India, the drugs in the watch category have long crossed the 10% resistance mark. Even worse, Indians are becoming more and more resistant to some of the precious few drugs in the reserve category as they enter the human body through meat. The reserve category drug, colistin, for instance, is used to fatten the chickens in poultry farms.
India is now starting to look deep into this problem. Starting with a government conference in Kerala’s capital Thiruvananthapuram on 11 June. One that the deputy director of the national health mission in Madhya Pradesh (MP), Dr Pankaj Shukla, attended.
Shukla returned to MP, and at a never-before-for-an-Indian-bureaucrat pace, he framed and executed an antimicrobial resistance (AMR) action plan. In six weeks. As you read this, he’s giving final touches to it. Other states have also swung into action. Assam hosted its first meeting last week. Delhi has started the process to frame its action plan. The bureaucrats plan to finalise it next month. Shukla is ahead of the pack and plans to launch MP’s action plan on July 25.
The conference convinced Shukla that AMR, which is killing more and more Indians every day, can be controlled. By not feeding antibiotics to chicken in poultry farms. Shukla was astonished to learn that resistance to antibiotics could be so easily avoided. Moreover, the weight of the chicken and size of the egg remained the same, he says.
This chicken-and-egg solution is a precedent to a larger drive—an ‘antibiotic stewardship’ programme. And as per Dr Sanjeev K Singh, who instituted the programme in Kerala five years ago, it has led to a significant reduction in the use of antibiotics.
Singh, medical superintendent at Amrita Institute of Medical Sciences in Kochi, narrates the story of a 3-year-old boy who was brought to Amrita with congenital heart disease. He caught an infection that resisted all antibiotics; he died after three weeks.