Rational Antibiotic Use in Office Practice

Abstract

Antimicrobial resistance (AMR) is emerging as a global health threat. Microbial resistance emerged almost simultaneously with the discovery of penicillin and has kept pace with almost every new antibiotic molecule. With the increasing AMR and declining initiative for discovery of newer antibiotics from research and pharmacologic industry, humanity may be entering a post-antibiotic era of inability to treat any infection. As per the global estimate, AMR ranks as high as the third leading cause of death. India being the largest consumer of antibiotics faces a huge burden of AMR. ICMR data reveals that methicillin resistant Staphylococcus aureus (MRSA) prevalence is in more than half the specimens and among the Gram negative organisms, carbapenem resistance is seen in nearly 50% in E. coli and klebsiella in 2023.The contributory factors for AMR are patient, prescriber, system and environment related, as well as the rampant use of antibiotics in animal husbandry, aquaculture and biocides. Government of India is making efforts to restrict AMR through a National Action Plan by strategies such as enhancing knowledge about AMR, improving Antimicrobial Stewardship, monitoring antibiotic use and increasing coordination among stakeholders under 'One Health' initiative. To promote rational antibiotic choice and prevent AMR, WHO has categorised antibiotics as per the level of need as Access, Watch and Reserve (AWaRe) antibiotics. Robust National and WHO guidelines are available to treat all the infections encountered in office practice.

Keywords: AWaRe; Antimicrobial resistance; Antimicrobial stewardship; National action plan; Office practice; One Health.