The National Medical Commission (NMC) has asked medical colleges to set up antimicrobial stewardship committees to study drug resistance among patients.
“The extent of antimicrobial resistance has reached alarming proportions and poses a serious threat to the patient’s clinical outcome,” said Dr Ambika R, head of the microbiology department at the Bangalore Medical College and Research Institute (BMCRI).
Despite the NMC’s directive, none of the 17 medical colleges in the state has set up the antimicrobial stewardship committees.
These committees will deliberate whether first-line drugs were prescribed before exploring more advanced, powerful drugs. If milder drugs are skipped, patients will become resistant to treatment and will require third-line drugs every time they fall sick and will have fewer options if they are admitted to the ICU.
Dr Ambika said that antimicrobial resistance patterns were discussed during the monthly meetings of the hospital infection control committee and promised that the antimicrobial stewardship committee would be constituted by the end of this week.
The BMCRI’s stewardship committee will have 15 members drafted from the departments of microbiology and pharmacology besides clinical departments like medicine, surgery, obstetrics, gynaecology and paediatrics. It will also have biomedical engineers.
“We’ll go to different wards to verify the medicines patients have been given as part of the treatment protocol,” Dr Ambika said.
The infection control committee, she said, will focus only on security, hospital cleaning, disinfection, surveillance of operation theatres and labs.
Dr P G Girish, Director, Medical Education Department, admitted he had not heard of antimicrobial stewardship committees in any government medical college. “So far, only infection control committees existed,” he said, adding every college will constitute the panel.
The BMCRI’s antibiotic policy has been in effect since September 30, 2019, and categorises antibiotics into restricted use, limited access and under surveillance. “The objective is to ensure appropriate antimicrobial treatment while at the same time limiting the inappropriate use of antibiotics in the management of infections by addressing issues like antibiotic selection, dosage, route, duration and adverse drug events,” the policy document reads.
Dr Ambika said the policy covered several important aspects and gave the example of surgical antimicrobial prophylaxis, a treatment given for disease prevention that should be administered in one hour before the surgical incision. “Only a single dose is recommended. Prophylaxis shouldn’t be given beyond duration of the surgery except in cardiothoracic surgery where it’s permitted up to 48 hours,” she explained.
What is antimicrobial resistance?
Antimicrobial resistance occurs when bacteria, viruses, fungi and parasites mutate over a period of time and stop responding to drugs, making infections harder to treat and increasing the risk of disease spread, severe illness and death.