The World Health Organization published its first-ever guidance on antibiotic pollution from manufacturing.
- The emergence and spread of AMR (antimicrobial resistance) caused by antibiotic pollution could undermine the effectiveness of antibiotics globally, including the medicines produced at the manufacturing sites.
What is Antimicrobial Resistance (AMR)?
- AMR is when bacteria, viruses, fungi, and parasites stop responding to antimicrobial medicines, resulting from genetic changes accelerated by misuse and overuse of antibiotics.
- Pathogens evolve to survive treatments, leading to the creation of “superbugs.”
- These drug-resistant infections cause complications in healthcare and are especially dangerous for patients with multiple diseases.
Impact of AMR:
- Human and Animal Health: 1.27 million deaths in 2019 were attributed to drug-resistant infections. The WHO ranks AMR as one of the top 10 threats to global health.
- Environment: Antibiotic residue in wastewater pollutes rivers and the land, contributing to biodiversity loss and the rise of zoonotic diseases.
- Food Security: AMR threatens agriculture and animal husbandry, putting food supply chains at risk.
- Economy: Increased healthcare costs, productivity losses, and a rise in poverty are direct economic consequences of AMR.
Key Reasons for Increasing AMR:
- Overuse by Individuals: Misusing antibiotics for viral infections like influenza contributes to resistance. Many individuals, instead of consulting doctors, self-prescribe antibiotics, often from local chemists.
- Doctors’ Practices: Over-prescription of broad-spectrum antibiotics is a significant contributor to AMR. In hospitals, 55% of antibiotics are used to prevent infections, not treat them.
- Pharmaceutical Pollution: Antibiotic pollution from manufacturing facilities contributes to the emergence of drug-resistant bacteria, posing a global threat. The WHO guidelines on antibiotic pollution aim to address these concerns, but regulation remains largely ineffective.
Common Resistant Pathogens in India:
- E. coli: Resistance to antibiotics has increased, with susceptibility to carbapenem dropping from 81.4% in 2017 to 62.7% in 2023.
- Klebsiella pneumoniae: A reduction in susceptibility to carbapenem-based treatments from 58.5% to 35.6% between 2017 and 2023.
- Acinetobacter baumannii: 88% resistance to carbapenems in 2023, posing a high risk in hospital-acquired infections.
Initiatives to Combat AMR:
- One Health Approach: A holistic method that integrates human, animal, and environmental health.
- WHO GMP (2020): Includes environmental guidelines for managing waste from antibiotic manufacturing.
- National Action Plan (NAP-AMR), 2017: India’s effort to tackle AMR includes banning inappropriate drug combinations and promoting vaccinations.
What Needs to Be Done?
- Prevention: Focus on hygiene, sanitation, and vaccination to reduce infections and reliance on antibiotics.
- Education: Doctors should prescribe narrow-spectrum antibiotics only when necessary and based on diagnostic tests.
- Regulation of Manufacturing: Implement stricter controls on pharmaceutical waste to reduce antibiotic pollution.
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Frequently Asked Question:
What is antimicrobial resistance (AMR)?
AMR refers to the ability of pathogens to resist antimicrobial treatments, often caused by the misuse and overuse of antibiotics.
What are common AMR pathogens in India?
Pathogens like E. coli, Klebsiella pneumoniae, and Acinetobacter baumannii show high resistance to carbapenems in India.
What is the One Health approach to AMR?
The One Health approach integrates human, animal, and environmental health to combat AMR on multiple fronts.
Why is hygiene important in preventing AMR?
Good hygiene practices reduce infections, limiting the need for antibiotics and helping prevent the spread of drug-resistant bacteria.