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Times of India
31 August 2010
By Pushpa Narayan
Chennai, India

Decision After Study Blamed India For New Superbug That Emerged From Abuse Of Antibiotics
Antibiotic Policy For The State Soon
Two weeks after Lancet, a medical journal, reported the emergence of a superbug in the country, the Tamil Nadu health department has decided to constitute a panel to frame an antibiotics policy. From restricting free access to higher–spectrum antibiotics to making infectioncontrol committees mandatory for all hospitals, the policy is expected to address a wide range of issues related to infections. The state will also start an active registry for hospital–acquired infection.

The decision was taken after a panel of 23 experts including senior doctors, microbiologists, virologists and pathologists from government and private hospitals met health secretary V K Subburaj at the state secretariat for a preliminary round of discussions. "None of them agreed that India was a source of such infections and that treatment here would increase risk. At the same time, we know we can no longer go on without an antibiotic policy and an infection registry," Subburaj said.

The Lancet report, published earlier this month, suggested that NDM–1, a superbug that was resistant to antibiotics, emerged from India. It also advised UK patients not to come to India for treatment. As a broad framework, it was decided to make it mandatory for all hospitals to have infection control committees. "If antibiotics of a certain class are prescribed, the committee will have to approve this," Subburaj said, though he admitted that with the present system, it would be difficult for the state government to monitor prescriptions of all private hospitals.

"Private hospitals don’t come under the state government control anyway. But to make this work, we are planning to bring in restrictions over the sale of antibiotics," the health secretary said.

The directorate of drugs control has been asked to look at provisions in the Drugs and Cosmetics Act to make double–prescriptions mandatory for some class of high–grade antibiotics. "During the sale of psychotropic drugs like morphine, prescription is retained by the pharmacist. The drug store has to retain the name, address and the prescription of the patient. This not only makes tracking easy but also reduces abuse," Subburaj said.

The King Institute of Preventive Medicine in Guindy will be state’s nodal agency that will network with hospitals across the state for a detailed study on infections in hospitals. "The first step towards infection control is to provide an aseptic environment. We want to study the source of infections, the cause, how it spreads and where it breeds. A couple of years ago, there was an uproar in the UK after they found doctor’s coats and ties to be carriers of infections. They banned the doctor’s coat in some sterile zones. We will have to study our problems and come up with solutions," said King Institute deputy director Dr P Gunasekar. Short–term and long–term studies are now being worked upon by researchers, he said.

On The Anvil Are...

What are suprebugs | They are normal bacteria that have mutated so much that regular antibiotics used to treat them are no longer effective.

They cause pneumonia and infections of the urinary tract, blood stream and other parts of the body

How does it spread | Most hospital–acquired infections are transmitted through open wounds, nostrils and urinary tract. Infection can spread when healthcare workers tend to wounds with hands that carry bacteria or when needles infected with such microorganisms are injected into the blood stream

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