ICMR: Hospitals flouting antibiotic regulations

Aditi Tandon

Tribune News Service

New Delhi, December 6

After India recently reported the highest rate of antibiotic resistant bacteria in the world in a survey of 40 nations, the Indian Council of Medical Research (ICMR) has shown that tertiary hospitals in the country are potential breeding grounds for drug resistant bacteria that threaten effectiveness of treatment rendering several infections hard to address.

The ICMR set alarm bells ringing after its first-ever survey of the use of antibiotics in healthcare institutions showed that half of those surveyed were not implementing the critical Antimicrobial Stewardship Programme (AMSP), developed in 2013 to ensure effective antibiotic prescription to prevent resistance from developing.

The AMSP is among the best known methods of prolonging the shelf life of existing and new anti-microbial agents (AMAs) and is critical because while existing antibiotics continue to be abused, newer ones are hardly being developed.

The ICMR study covering 20 tertiary hospitals (12 government and eight private) across the country revealed that only half had functional AMSP teams and 40 per cent had written AMSP documents to follow. The study concluded that on all aspects of healthcare delivery, private hospitals outperformed government ones that lacked accreditation. Written AMSP documents for instance were available with six private and just two government institutes.

Another shocking finding is that none of the 12 government hospitals had an infectious diseases department. "Only three private hospitals have the infectious diseases department that is essential for effective functioning of antibiotic stewardship programme and diagnosis and treatment of difficult infections. Another critical part of the AMSP team is a clinical pharmacist who determines the appropriateness of antibiotics by analysing prescriptions and dosing patterns to reduce infection rates from resistant strains. Only five hospitals among 20 had a clinical pharmacist and of these four were private," says the ICMR study that recommends mandatory accreditation of government hospitals to ensure standardised healthcare delivery.

Dr Kamini Walia of the ICMR, lead author of the study, said, "The situation is alarming. With the dangers of antimicrobial resistance rising, it is critical to address gaps in the AMSP implementation in hospitals, especially government hospitals none of which were found accredited in our survey. Among all government hospitals, we found only one department at the PGI Chandigarh accredited."