The policy, the result of two years of meticulous work, means there will be uniformity in prescribing drugs for fever, malaria, urinary tract infection to cardiac or knee replacement surgery across the BMC's three medical colleges and 16 peripheral hospitals.
The implementation of the Antibiotic Stewardship Programme will be followed by an audit to check if doctors are adhering to it. The pocket-sized ready reckoner, colour-coded as per specialties, will shortly be given to all professors and department heads, who, in turn, will train resident doctors. A team of experts, including clinical pharmacologists and microbiologists, will be studying the drug prescribing pattern of doctors.
Dr Suhasini Nagda, director, major hospitals, said antimicrobial stewardship is the need of the hour to combat antibiotic resistant superbugs. "It includes appropriate selection of antibiotics, dosing, route of drug delivery and duration of therapy. It's our first step towards reducing drug resistance in our hospitals and rationalizing the use of antibiotics."
The policy, though not binding on others, could be picked up by private hospitals and doctors voluntarily in the absence of national guidelines. In times of outbreaks of swine flu and malaria, standard operating procedures worked out by the BMC (or other governmental bodies) are widely circulated and practised.
While Indian data is scarce, US' Center for Disease Control and Prevention shows antimicrobial resistance causes over 2 million illnesses and 23,000 deaths there. The situation assumes urgency in India given its extraordinary bacterial burden and indiscriminate antibiotics use.
A 2011 report by the Indian working group of Global Antibiotic Resistance Partnership had shown that antibiotic use in India jumped 40% between 2005 and 2009. The paper highlighted how doctors prescribe antibiotics even for common cold and diarrhoea that can be treated with simple oral rehydration. A more recent Lancet (UK medical journal) study had said countries such as Brazil, Russia, India, China and South Africa accounted for 76% of the global increase in antibiotic consumption.
The BMC's policy comes on the heels of the Barack Obama government coming out with a five-year action plan for combating antibiotic-resistant bacteria and committing a sum of $1.2 billion.
"It shows the urgency of the situation. Management of common and lethal bacterial infections has been critically compromised by the rapid spread of antibiotic-resistant bacteria. The medical community is to blame for rampantly prescribing antibiotics, even when the infection source could be a virus," said Dr Jayanti Shastri, head of microbiology at BYL Nair Hospital. She and head of microbiology at KEM Hospital Dr Gita Nataraj coordinated with all departments and drafted the guidelines.
Dr Om Srivastava, head of infectious diseases at Jaslok Hospital, called for better surveillance at the national level while changing patient mindset."Patients often demand antibiotics but doctors cannot fall for public sentiments. Resistance to fourth generation antibiotics such as carbapenems is alarming," he said.
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