Inappropriate antibiotic prescriptions for simple ailments like cough and cold is mainly responsible for superbugs: Australian Report

Contributed by: Siddarth David & Dr. Tamhankar

Australian Commission on Safety and Quality in Healthcare (ACSQH) published a crucial report on antibiotic use in the country last week that showed that it was inappropriate use in the primary level care that is responsible for antibiotic resistance and multi-drug resistant superbugs. The Antimicrobial Use and Resistance in Australia (AURA) 2016 analysed data for the last 18-months in Australia.

The report showed that in most health facilities more than one in 10 patients were on some sort of antibiotic, but less than five percent had a suspected or confirmed infection. It also said that one in five prescriptions were written for people with no signs or symptoms of infection. Moreover, more  than half of people with colds or other upper respiratory infections were prescribed antibiotics, despite the drugs being powerless against viruses. All of this contributed to making, according to the report this contributed to roughly 500 superbug cases are detected in Australia every year.
It recommended boosting community education, potentially in schools, and awareness campaigns to wean the public off its perceived need for antibiotics.

The report is another crucial piece of evidence to push for stricter norms in countries across the world along with public awareness on the harmfulness of popping antibiotics for simple infections. Such norms and awareness can alone help battle the critical issue to antibiotic resistance.
 

Researchers in Singapore discover safer and better alternative to triclosan

Contributed by: Siddarth David & Dr. Tamhankar
 

The researchers at the Institute of Bioengineering and Nanotechnology (IBN) in Singapore have made a break through discovery and found an alternative to triclosan. Triclosan an antibacterial compound is widely used in household cleaning products but recently, its application is increasingly being restricted due to concerns about its contribution to antibiotic resistance in bacteria. This required alternatives in order to continue the struggle against antibiotic resistance. 

The new substance consists of "imidazolium oligomer" can penetrate the cell wall of the bacteria and destroy them. In tests, the substance killed 99.7% of Escherichia coli in less than 30 seconds. It eradicated 99.9% of the bacteria Staphylococcus and Pseudomonas and Candida within two minutes. This compound is also safe for use in humans because it carries a positive charge that targets the more negatively charged bacteria, without destroying red blood cells. The imidazolium chains are in the form of a white powder, which forms a gel when mixed with alcohol. The researchers say it could be easily incorporated in sprays and hand gels used for hand washing in healthcare settings and at home.

This is a wonderful discovery, given the rising antibiotic resistance and the need for simple techniques such as hand washing which will reduce microbial infections and thereby the over use of antibiotics. While this compound is yet to be used in manufacturing soaps, hand-washing with regular soap is still very effective in reducing infections and should be followed rigorously at hospitals and homes.

Mismanagement in Poultry Farms a threat for antibiotic resistance in India

Contributed by: Siddarth D & Dr. Tamhankar

A recent report, has shown that antibiotics are being indiscriminately used in some of India's poultry farms that supply to commercial outlets like Suguna Chicken, McDonalds and KFC in the country. The report uncovered that in the state of Telangana, poultry framers were using antibiotics on chickens without any set instructions. Interviews with farmers indicated that antibiotics, permitted only for veterinary use in India, were often viewed as vitamins and supplements by the farm owners and given to chickens. Poultry farmers were using levofloxacin, ciprofloxacin and gentamicin as regular medicines for the poultry without being aware of the consequences of using them. 

This alarming finding, reinforces the findings of study conducted by the Centre for Science and Education (CSE), New Delhi which found that nearly 40 per cent of poultry being sold in Delhi had high levels of antibiotics like ciprofloxacin.  S.K. Dutta, assistant commissioner of the department of animal husbandry in the Ministry of Agriculture and Farmers Welfare reacted to the report by saying that antibiotic use in animals was a critical area that has yet to be dealt with by policy, leaving many farmers to use them without prescriptions from their chemists. He stated that new measures would be introduced to address this problem.

Without clear policy guidelines in the country, India has yet to regulate the use of antibiotics in animals, which therefore remains unchecked and under studied. This report should be a waking call for health policy makers and experts that while there has been considerable work done on controlling antibiotic use in humans, neglecting use in animals can be serious obstacle in the battle against antibiotic resistance.

 

Basics can slow antibiotic resistance more effectively

Contributed by: Siddarth David & Dr. Tamhankar

The latest report from the Review of Antimicrobial Resistance a two-year effort created by Prime Minister David Cameron, supported by the Wellcome Trust to examine solutions to the rise of resistance, have highlighted that basic hygiene and improved sanitation can be a very effective tool in the process. It has indicated how the lack of clean water and sanitation both create diseases that demand antibiotic use, and also spread antibiotic-resistant bacteria.

The report highlighted that in just four emerging economies (India, Indonesia, Nigeria and Brazil), 494 million cases of diarrhoea each year are treated with antibiotics, a number that could rise to 622 million cases by 2030. If infrastructure were improved, 60 percent of those courses of antibiotics could be foregone. The report says that contaminated water also allows bacteria to cycle between humans and the environment, spinning up the dissemination of resistance genes. 

The Review also found that persistent neglect of simple tasks such as washing hands is fuelling the spread of resistance. As few as 30 to 40 % of hospital staff wash their hands as often as they should and interestingly doctors perform poorer than nurses or staff who are lower in the hierarchy. 

This shows that addressing the issue of antibiotic resistance is a multi-pronged approach and neglecting basic public health issues like clean water, safe sanitation and hygiene practice can play major role in reducing antibiotic use and therefore resistance. We need India need to also deal with the these public health issues in the efforts to curb antibiotic resistance.

 

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.