Antimicrobial resistance (AMR) is the ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals and antimalarials) from working against it. As a result, standard treatments become ineffective, infections persist and may spread to others.

Microorganisms that become resistant to most antimicrobials are often referred to as “superbugs”. It compromises medical procedures such as organ transplantation, cancer chemotherapy, major surgeries etc. making them very risky.

Carbapenem Antibiotics – Refer to the line of last resort drug used to treat people with life-threatening infections.

Causes of Antibiotic Resistance

Microorganisms in the news who have shown signs of resistance.

Resistance in Klebsiella pneumoniae – common intestinal bacteria that can cause life-threatening infections – to a last resort treatment (carbapenem antibiotics) has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, and infections in newborns and intensive-care unit patients.

Resistance in E. coli to one of the most widely used medicines for the treatment of urinary tract infections (fluoroquinolone antibiotics) is very widespread. There are countries in many parts of the world where this treatment is now ineffective in more than half of patients.

Treatment failure to the last resort of medicine for gonorrhoea.

Colistin is the last resort treatment for life-threatening infections caused by Enterobacteriaceae which are resistant to carbapenems. Resistance to colistin has recently been detected in several countries and regions, making infections caused by such bacteria untreatable.

Besides these – Malaria, TB, HIV, etc all have shown signs of developing resistance.

International Initiatives

• ‘One Health’ approach: to designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes against the food safety, the control of zoonoses (diseases that can spread between animals and humans, such as flu, rabies), antimicrobial resistance etc.
• In 2015, the WHO released a Global Action Plan on AMR (GAP-AMR) urging member countries to develop national action plans by May 2017.
• The Global Antimicrobial Resistance Surveillance System
• Interagency Coordination Group on AMR (IACG)
• World Antibiotic Awareness Week.

Initiatives by India 

1. India recently has launched National Action Plan on Antimicrobial Resistance.

Six strategic priorities have been identified under the NAP-AMR
1. Enhancing awareness among masses and strict adulteration laws.
2. Strengthen knowledge and evidence through surveillance.
3. Optimize the use of anti-microbial agents.
4. Reducing infections
5. Promote investments, research, and innovations.
6. Strengthen leadership on AMR through international collaborations

2. A National Policy for containment of Antimicrobial Resistance (AMR) in the country was formulated in the year 2011 and has been widely disseminated. The said policy envisages enforcement and enhancement of regulatory provisions for use of antibiotics for humans as also for veterinary use.

3. The Drugs and Cosmetic Rule, 1945 were amended in 2013 to incorporate a new Schedule H1 under the said rules containing 46 drugs which include IIIrd and IVth generation antibiotics, anti TB drugs and certain habit forming drugs for having strict control over the sale of these drugs.

4. FSSAI has set certain guidelines limiting the antibiotics in food products such as fish and honey.

5. Red Line Campaign on Antibiotics 2016, was launched to create awareness regarding rational usage and limiting the practice of self-medication of antibiotics among the general public.

6. National Health Policy 2017 envisions a holistic framework against AMR.