SUPER BUGS: The impending epidemic for the world

Many global health crises that occur are dramatic like SARS, Ebola, or Zika. New or old diseases erupt or re-emerge, causing serious illness, suffering, and death, traveling swiftly around the world, creating fear and damaging economies.

If you have never heard about Super bugs or Antibiotic microbial resistant (AMR) bacteria you must know it because they are upcoming epidemic or i must say future pandemic. The awareness on this issue is much needed especially for those countries where antibiotics are over prescribed for a simple ailment like flu, cold or minor cough.

So what are Super bugs?

Since the discovery of the first antibiotic Penicillin in 1928 by Alexander Fleming for treatment of bacterial infection the use of antibiotic has increased much. Now there are various families of this antibiotic which are newly discovered and have much enhanced effectiveness in treating bacterial infection.

Superbugs are microbes/bacteria that have developed resistance to most of the antibiotics and very difficult to treat by Medical professionals. From where they developed this resistance is much important issue now.

By Centers for Disease Control and Prevention - Antibiotic resistance threats in the United States, 2013, Public Domain, Link

If you still want to know how these super bugs get power to overcome most of antibiotics i suggest you to read these good articles written by @JustTryMe90 1. article, 2. article and 3. article

But my purpose to write this article is to what extent the super bug problem has come to us

I was reading article on THE HUFFINGTON POST dated 31/10/2015 about superbugs http://www.huffingtonpost.in/open-magazine/how-india-became-the-anti_b_8440100.html

The problem is getting worse day by day in dealing with super bug NDM1(New Delhi metallo-beta-lactamase) by antibiotics. Where every antibiotic that was given by doctor to mange it still patient health deteriorated. In India doctors are using every antibiotic even the last resort antibiotic to tackle simple infections for there patients. What doctors in India are realizing now in India is that they are dealing now with deadly epidemic and only few are knowing them in India alone.

This bacteria has been isolated in india from water, sewage,soil and even has been reported to be detected in some indians itself.

There is another article written by aljazeera where they have uncovered how several indian newborn babies are dying due to the Superbugs. http://www.aljazeera.com/indepth/features/2016/08/killing-india-babies-160810134404255.html

India as epicenter to superbug epidemic?

Despite the fact that antibiotics are consumed used much in number in india still the Indian higher authorities are denying this matter and taking up responsibility. Still Indian studies are going up to what extent the problem of superbug is.

There were 2 newborn case reported in early 2015 in KEM Pune hospital of India that had developed resistant even to the last resort antibiotic colistin. Indian doctors themselves have agreed that it’s a worrying situation for them that conditions are know have gone this far they are left with no antibiotics.

The situation is similar in china where a gene mcr-1 found in E.coli bacteria that have resistance to colistin antibiotic. The resistance gene has been reported in at least 20 more countries.

Colistin is used by some Indian farmers to promote growth and prevent disease in poultry flocks. This overuse of colistin has been hypothesized for drug resistance.

So how much India is responsible for superbug NDM 1?

In my practice of medicine in India and during my training for medicine i can tell you that India is fully responsible for this Super bug NDM 1 creation.

1. Doctors:

Indian doctors have over prescribed anit-biotics to such a extent that even for small ailments they are using ciprofloxacin and other drugs that bacteria have become almost fully resistant to these first line drugs. The use of carbipenems and beta lactams here is in extensively used which should have been used after first line antibiotics. This is all because pharmaceutical companies are giving incentives to doctors to use these drugs more so they can get more profits out of it. This is what situation is and there is no regulation to stop this over prescription by doctors.

2. Pharmacist and pharmaceutical companies:

Pharmacists themselves prescribe antibiotics and they do not do any follow-up as it is not their responsibility. This unethical practice of dispensing scheduled drugs without a valid physician’s prescription is really killing antibiotic therapy itself. Patients, in order to save a few rupees in doctor’s fees, go directly to the pharmacy and get whatever they want. The indian government is sleeping over this raging corrupt practice.

A Research study published by researchers from Princeton University in 2014 studied that between 2000 and 2010, discovered that India now consumes the most antibiotics in the world. In 2010, India is estimated to have consumed 12.9 billion antibiotic pills. In comparison, China consumed 10 billion pills and the US, 6.8 billion. While antibiotic usage worldwide in the first decade of the 21st century rose by 36 per cent, in India, the count went up by 62 per cent, from 8 billion pills in 2001 to 12.9 billion in 2010. This shows how much antibiotics production pharma companies in India are making as there is regulations for it tackle the overproduction of drug.

3. Indian Government:

No strict regulations and protocols that how and who can prescribe antibiotics has created such a situation that its now out of hand in india. Still Indian government denies this fact they are not accountable for this situation and blames Superbug NDM-1 has been named after the capital new delhi just to destroy there health tourist industry

World at risk

According to WHO(World health organization) Super bug has potential to be even more deadly than cancer, to kill as many as 10 million people a year and, according to a recent review undertaken by the United Kingdom, to cost the world economy as much as $100 trillion annually. Left unchecked, AMR will make chemotherapy and common dental and surgical procedures increasingly risky, as infectious complications become difficult or impossible to treat. The gains in health and longer lives of the 20th century are at stake.

Solution:

There is need of awareness of antimicrobial resistance and promoting behavioural change through public communication programmes that target different audiences in human health, animal health and agricultural practice as well as consumers is critical to tackling this issue.

A strict control over this illicit corrupt use of anti biotics is much needed in countries where they are used as such. Government regulations and policy to curb at national level for every country. WHO has already addressed concerns and has given public warning to the countries where it has been overused.

To sum up i will end article with this quote

"The time may come when penicillin can be bought by anyone in the shops. There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant."

• Alexander Fleming at his 1945 Nobel Prize lecture

References

1. https://www.bloomberg.com/politics/articles/2017-02-05/from-toilet-seats-to-cosmetics-koreans-fret-as-china-ups-ante
2. http://www.aljazeera.com/indepth/features/2016/08/killing-india-babies-160810134404255.html
3. http://www.huffingtonpost.in/open-magazine/how-india-became-the-anti_b_8440100.html
4. http://www.livemint.com/Opinion/l3d3INEWDLBtNIEPE1PJ1H/Resisting-antibiotic-resistance.html
5. http://www.huffingtonpost.com/dr-monique-eloit/post_13193_b_11992538.html
6. http://www.who.int/mediacentre/commentaries/superbugs-action-now

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