A directive from the National Medical Commission (NMC) states that prescriptions for antibiotics must be accompanied by diagnostic tests demonstrating the need for them. This instruction is a reaction to the growth in antimicrobial resistance (AMR) brought on by the increased usage of antibiotics in recent years. A 156-page document named “National Action Plan on Antimicrobial Resistance (NAP-AMR) Module for Prescribers” has a complete set of prescription recommendations that the NMC has distributed to medical institutions. The paper is intended for use by senior residents as well as educators.
Microbes that have been exposed to high-grade antibiotics over time may acquire resistance to these medications, a condition known as antimicrobial resistance (AMR). This resistance increases the risk of serious disease and fatality by making the treatment of common infections more difficult. Additionally, AMR reduces the ability of antibiotics to prevent subsequent infections during chemotherapy, orthopedic procedures, and the treatment of persistent infections. In essence, the microorganisms turn into superbugs, which make treating previously treatable illnesses much more difficult.
The complexity of infections—which can be bacterial, viral, fungal, or parasitic—makes such strict rules necessary. The guidelines stress how crucial it is to correctly diagnose the clinical issue and make a differential diagnosis at the patient’s bedside. This method helps in the decision of whether to start antimicrobial therapy. In order to determine the risk of infection based on symptoms and indicators, a comprehensive evaluation of the patient’s medical history is advised. It is essential for this examination to comprehend the typical presentation patterns of a variety of diseases, including meningitis, diarrhea, upper respiratory tract infections (URTI), lower respiratory tract infections (LRTI), urinary tract infections (UTI), and skin and soft tissue infections.
The recommendations support the use of a syndromic approach as the first step in patient classification. Patients presenting with an acute febrile sickness with rash may be suffering from bacterial illnesses such as scarlet fever, viral infections such as dengue or malaria, medication reactions, autoimmune diseases, or other infections. Acute febrile sickness with jaundice is a subtype that encompasses bacterial illnesses such as typhoid, viral infections such as hepatitis, and biliary system infections. Acute febrile illness with respiratory syndrome includes infections such as pneumonia and flu, whereas acute febrile illness with neurological involvement suggests problems such as meningitis. According to the guidelines, the majority of respiratory ailments can be managed symptomatically and self-limit viral infections, negating the need for antimicrobials.
On the other hand, pneumonia should be suspected in a patient presenting with respiratory symptoms together with evidence of septicemia and expectoration. In these situations, a sputum sample ought to be sent to the lab for examination; the results of the analysis could then be used to start an empirical antibiotic treatment.
The guidelines suggest that in the case of urinary tract infections (UTIs), antimicrobials may be started empirically in specific circumstances, such as in individuals who have diabetes or during pregnancy. Then, based on data that are already accessible, these treatments can be modified to guarantee that the most effective therapy is given.
This method emphasizes how accurate antibiotic diagnosis and prescription are essential. AMR has spread due to the overuse and abuse of antibiotics, and it now poses a serious threat to public health around the world. Healthcare providers can lessen this risk by following the NMC’s instructions. Preserving the effectiveness of currently available antibiotics and guaranteeing improved patient outcomes need accurate diagnosis, prudent antibiotic usage, and ongoing monitoring. By encouraging a more methodical and evidence-based approach to antibiotic prescription, the guidelines hope to reduce the overuse of these potent medications and lower the rate of antimicrobial resistance.
SOURCE:
INDIAN EXPRESS
