This story is from September 25, 2018

Kerala: Tackling the source of drug resistance

Kerala: Tackling the source of drug resistance
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KOCHI: Kerala – first state to adopt a comprehensive policy in 2016 to fight growing antibiotic resistance – is now taking a big leap. Recognising that there are many drivers of antibiotic resistance, apart from inappropriate use of antibiotics, health department is now focusing on controlling antibiotic misuse in animals, horticulture and fisheries.
To curb anti-microbial resistance (AMR), government has prepared an all-inclusive action plan involving human health, animal, food and environment.
It will be launched soon. Antimicrobial resistance is the ability of a microorganism to stop an antimicrobial (antibiotics, antivirals) from working against it. As a result, standard treatments become ineffective.
DRUG

State government is now planning to strengthen and upgrade the microbiology labs to detect AMR. Besides monitoring the quality of anti-microbials, it will monitor animals, fisheries, dairy products and food for sample-bugdrug combinations. “We have to monitor the level of resistance. If there is an increasing trend, we must see whether our prescribed practices are proper. There are also non-human factors such as environment. Antibiotics in fisheries sector and animal husbandry are leading to AMR. We will now focus on them as they are interlinked,” said health secretary Rajeev Sadanandan.
Government will establish separate AMR databases for human, animal, food and environment. Also, standards for antibiotic residues in waste generated from farms, factories, human healthcare and veterinary care settings will be introduced. To create awareness about AMR among citizens, it will be introduced in school syllabus and the curriculum of medical students.
Government is also looking at measures to prevent the sale of NSQ (not-ofstandard-quality) drugs and over-thecounter sale of antibiotics. As per government estimates, the total consumption of drugs in the state is 20,000 crores per annum, with antibiotics making up 20% of the total drugs consumed annually in state.

Poultry farmers in Kerala also use a variety of antibiotics either as growth promoters or to control infections. Health experts said that many prescription medications used for human and animal health will ultimately find their way into the environment and affect the health and behaviour of animals.
“The magnitude of AMR is unclear in people as it varies from place to place and hospital to hospital and even in the same hospital it varies from OPD to IPD to ICU. In Kerala, AMR is more in ICU,” said Dr Arvind R, who heads the department of infectious diseases at Thiruvananthapuram Medical College.
The government will also rope in private hospitals. Already Amrita Institute of Medical Sciences and Aster Medcity are part of the government antibiotic control programme.
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About the Author
Preetu Nair

Preetu Nair, Deputy metro editor at The Times of India, Kochi, writes on crime and health, and issues related to women and children. She is interested in music, travelling and reading law books. In her free time, she likes to go trekking or play badminton.

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