WHO revised Antibiotics Protocol

June 24, 2017 June 24, 2017

The WHO has revised the Antibiotics Protocol and has divided the drugs into three categories-access, watch and reserve.

Features

WHO has kept the commonly used antibiotics under the ‘access’ category.
The antibiotics in the ‘access’ group can be made available all times for treatment of a wide range of common infections. The drugs kept under this category include amoxicillin, a widely-used antibiotic to treat infections such as pneumonia.
Slightly potent antibiotics have been placed under ‘watch’ category.
The drugs placed under the ‘watch’ category are recommended as first or second choice treatment for a small number of infections. Example: Ciprofloxacin. WHO has recommended that prescription of these drugs has to be reduced to prevent further development of resistance.
Highly potent drugs which are to be used only as a ‘last resort’ have been placed under the ‘reserve category’.
WHO recommends that antibiotics such as colistin which are placed in the ‘reserve’ category has to be prescribed only in the most severe circumstances when there is no other alternative available. It can be used to treat life-threatening infections caused by multidrug-resistant bacteria.

Significance

WHO’s revision of antibiotics is the biggest ever revision of antibiotics in the 40 year history of the essential medicines list (EML).
The misuse of antibiotics has led to the problem of antibiotics resistance. The categorisation will be able to help the health system planners and prescribers to ensure that people have access to the antibiotics and at the same time ensure that the problem of antibiotic resistance does not get worse.

What is Anti-microbial resistance? How is it developed?

Antimicrobial resistance occurs when microorganisms like viruses, bacteria fungi and parasites get altered when exposed to antimicrobial drugs. As a result, the antibiotics become ineffective. Resistance is developed due to overuse and misuse of antibiotics. Since, most of the antibiotics belong to the same class of medicines, resistance that gets developed in one organism spreads rapidly to the others.

Global Action Plan on Antimicrobial Resistance

WHO in its Sixty-eight World Health Assembly held in May 2015 endorsed a global action plan for tackling antimicrobial resistance. WHO has defined five strategic objectives to be followed in the coming years. They are:

Improve awareness and understanding of antimicrobial resistance through effective communication, education and training.
Strengthen the knowledge and evidence base through surveillance and research.
Reduce the incidence of infection.
Optimize the use of antimicrobial medicines in human and animal health.
Ensure sustainable investment in countering antimicrobial resistance.

Steps taken by India to curb Anti-microbial Resistance

India woke up to the menace of antibiotic resistance after a bug was named after New Delhi as the New Delhi Metallo-beta-lactamase-1 (NDM).

India’s Red Line Campaign

The Red Line Campaign was launched in February 2016 by the Union ministry of Health and Family Welfare for tackling the growing menace of antibiotic resistance across the country. The objective of the campaign is to curb irrational use of antibiotics and create awareness on the side effects of taking antibiotics without prescription. Under this campaign, antibiotics will be marked with a vertical red line. The red line antibiotics have to be consumed only on the advice of doctors and the patients are required to complete the full course prescribed by the doctor.

National Action Plan to combat Antimicrobial Resistance

In April 2017, Ministry of Health and family Welfare had unveiled a comprehensive and multi-sectoral National Action Plan to combat antimicrobial resistance in India. The National action plan has objectives of enhancing awareness, strengthening surveillance, improving rational use of antibiotics, reducing infections and promoting research.

National Anti-Microbial Resistance Research and Surveillance Network (AMRRSN)

ICMR has set up AMMRRSN to enable compilation of data related to AMR at the national level. Under this project, ICMR is carrying out the surveillance of drug resistance in the following six pathogenic groups: