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Wednesday, March 23, 2016

Antibiotic Resistance in children increasing across the globe: UK Study

Contributed by: Siddarth David & Dr. Tamhankar

A study published in the British Journal of Medicine (BMJ) showed that antibiotic resistance among children is rising.  A team of UK researchers from University of Bristol and Imperial College London set out to review studies investigating the prevalence of antibiotic resistance  in urinary tract infections caused by E. Coli, responsible for over 80% of all urinary tract infections (UTI) in children.  

The results show a high prevalence of resistance to some of the most commonly prescribed antibiotics for UTI in children. The study also found an association between previous exposure to antibiotics and subsequent resistance in the same child. The researchers also reviewed global studies on the topic and concluded that it was global phenomenon. If current trends persist, expert warn, it could lead to a serious situation in which relatively cheap and easy-to-administer oral antibiotics will no longer be of practical benefit to young UTI patients. 

This calls for a stronger approach to tackle the challenge of antibiotic resistance through stronger policies and regulations from the manufacturing to the prescribing to the consumption.

Thursday, March 3, 2016

India and WHO host International Conference on Antimicrobial Resistance in New Delhi

Contributed by:  Dr. Tamhankar & Siddarth David

Last week in New Delhi the International Conference on Antimicrobial Resistance was held by the Ministry of Health and Family Welfare, India and the World Health Organization (WHO) Regional Office for South Asia. The conference aimed to highlight the health and economic problems created by excessive use of antibiotics and the measures taken to address them. 

The event  saw senior representatives from the Government of India, join health ministers from across the region, and representatives from industry and civil society to discuss important aspects of this global problem. The event re-iterated the need for all the countries in the region to adopt for national action plan to combat the problem. 

The health minister Mr. J P Nadda said that India is committed to combating Antimicrobial Resistance (AMR). However, a collective action is required by all stakeholders within the country and also by all countries within the region. India, will be very happy to work with other Member States to achieve the common goal of AMR containment. He further stated that the complexity of AMR is also fuelled by numerous stakeholders impacting and impacted by AMR.
These include the consumers or the patients who take the medicine, doctors who prescribe, pharmacists who dispense, the industry which manufactures, the Government which regulates, the research organizations which innovate, the animal and agricultural sector which contribute to the food chain, the hospitals which treats the patients, the Civil Society which articulates the peoples’ perspectives, and the media which can focus attention on this important issue. Given this scenario, the Health Minister pointed out that it is imperative that all stakeholders connected with AMR contribute to pave the way for effective action to combat AMR. He also pointed out to the grave economic consequences that countries across the world are facing due to non-rational use of antibiotics. He emphasized on correct prescription practices, prescription audits and digital repository of patients’ medical history among other important measures to be taken to combat the growing misuse of antibiotics. He extended India’s commitment and resolve to work with other countries towards combatting this problem. 

Also present at the conference were, Mr. Tandin Wangchuk, Health Minister of Bhutan; Mr. Ram Janam Chaudhary, Health Minister of Nepal; Mr. Mohamed Habeeb, Minister of State for Health, Maldives; Dr. Poonam Khetrapal Singh, Regional Director, World Health Organization, South East Asia Region and Dr. Keiji Fukuda, Assistant Director General, World Health Organization. 
The Indian health minister also used the platform to launch the media campaign of 'Medicine strips with Red Line' that sought to help create mass awareness against misuse of antibiotics. This event was in keeping with the 68th session of the World Health Assembly proceedings presided over by India in Geneva in May 2015 which adopted a Global Action Plan on antibiotic resistance . It planned to prepare a blueprint with specific actions and timelines for the WHO as well as member states to address the growing threat of resistance.In the coference, Dr. A.J. Tamhankar, national coordinator of Indian Initiative for Management of Antibiotic Resistance (IIMAR)  was invited to present his views on "Role and Perspectives of Civil Society in combating Antimicrobial Resistance".  IIMAR expressed the views that 
  • Civil society and Governments or institutions (WHO) should have a Symbiotic Relationship.Civil groups should be used as Ears, Eyes and Extended appendages by institutions/Govt.- EEEs. Eyes and ears for getting information from society; Appendages for spreading useful messages.
  • Healthcare worker`s organizations should be used extensively to create awareness. Scientists, microbologists, Healthcare Workers should be encouraged to form local civil Societies to spread AMR awareness.
  •  Antibiotic residues and Antibiotic resistant bacteria in Environment,  Antibiotic use in Animals  (both therapeutic and growth promoters), and industrial effluents are a major threat and must be given due importance in policies on AMR containment. Current emphasis on Clinical and human AB/ABR monitoring and related interventions alone will NEVER solve the AMR problem. 
  •  Following “Location Specific Integrated Antimicrobial Resistance management strategy ” (Tamhankar, 2008). And A “One Health approach” (For Role model -see 'Protocol paper on one health' -BMC public health, 2015) is the need of the hour.             
  • (On behalf of Dr. Tamhankar, Dr. Ramesh  Nachimuthu, Joint Coordinator, IIMAR presented the views). 

The deliberations were conducted in the following 9 session:
1.  Antimicrobial Resistance: The Global Picture and follow up on WHA Resolution.   Chair : Dr Poonam Khetrapal Singh, Regional Director, WHO, SEARO,       Co Chair: Mr  B. P. Sharma, Secretary Health, MoHFW
2.  Rational use of antimicrobials, Chairs: Hon’ble Mr Ramjanam Chaudhary, Minister of Health, Ministry of Health, Co-Chair: Prof(Dr.) Jagdish Prasad, DGHS
3. AMR in health care setting: Infection prevention and Control, Chair: Dr Carmem LĂșcia Pessoa-Silva, WHO HQ, Co-Chair:  Dr Rajesh Bhatia  
4. Policy/Strategy perspective for combating AMR: International experiences, Chair : Dr S. Venkatesh, Director, National Centre for Disease Control, New   Delhi, Co Chair: Professor Thet Khaing Win (Mr) Permanent Secretary, Ministry   of Health, Myanmar
5. Surveillance for AMR in humans, animals and the environment, Chairs : Prof. Dame Sally Davies, Chief Medical Officer, UK, Co-Chair: Dr Henk Bekedam, WHO Representative to India.
 6. Industry Perspectives: R &D on Combating AMR and Follow up on the Industry  Declaration on AMR, Chairs : SEAR Minister ( Bhutan) Co-Chair: Dr Sudanshu Pant, JS, Department of Pharmaceuticals, MoHFW

7. Role of Regulatory Authorities in combating AMR, Chair : Mr Pawan Aggarwal,  CEO, FSSAI, Co-Chair: Mr KL Sharma, JS (Drugs), MoH&FW

 8. Research and Innovation for Combating AMR, Chairs: Dr SoumyaSwaminthan, Secretary DHR and DG ICMR, Co- Chair: Prof. Vijay Raghavan, Secretary, DBT

9. Civil society Perspectives for Combating AMR( Panel Discussion) Chairs : Dr AK Panda, Addl Sec, MoHFW, Co-Chair: Dr Arun Thapa, DPM, SEARO