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EDITORIAL |
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| Year : 2011 | Volume
: 14
| Issue : 2 | Page : 77 |
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Antimicrobial resistance: Neurologists role in containment and prevention
Sanjeev V Thomas
Editor, Annals of Indian Academy of Neurology, Room 1409, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695 011, India
| Date of Web Publication | 7-Jul-2011 |
Correspondence Address:
Sanjeev V Thomas
Editor, Annals of Indian Academy of Neurology, Room 1409, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695 011
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0972-2327.82785
How to cite this article:
Thomas SV. Antimicrobial resistance: Neurologists role in containment and prevention. Ann Indian Acad Neurol 2011;14:77 |
The world Health Organization has set the theme for 2011 as 'Antimicrobial resistance: No action today, no cure tomorrow'. This call for action has come about seventy years after an antibiotic was ever used in clinical situation. Antibiotics, together with antisepsis and asepsis have probably saved more lives than any other medical interventions. Regrettably, medical professionals had taken complacent stand that infections are controlled forever. The reality had gradually emerged that most organisms have the potential to become resistant to antibiotics and other antimicrobial agents. Multidrug resistant tuberculosis (MDRTB) is a major public health problem. WHO had estimated that there were more than 440,000 cases of MDRTB in the world 2008 and nearly a third of them proved fatal. Neurologists need to familiarize themselves with the recent advances in population based management of tuberculosis, directly observed treatment (DOT) and its application in the containment of drug resistant tuberculosis of the central nervous system. Drug resistant malaria is another emerging health care problem. Metalo beta lactamase (NDM 1) enzyme positive bacteria are the latest entrants in this field of antimicrobial resistance. Drug resistance may spread across the world and become a global threat in a very short time period. [1] Drug resistance emerges through the selective propagation of resistant strains of organism often due to the inappropriate use of antibiotics. The recently recognized NDM 1 positive gram negative organisms were isolated from patients with urinary tract infections, pneumonia or infection in the blood stream. To quote from the WHO handout [2] antimicrobial resistance is driven by (1) inadequate national commitment to a comprehensive and coordinated response, ill-defined accountability and insufficient engagement of communities; (2) weak or absent surveillance and monitoring systems; (3) inadequate systems to ensure quality and uninterrupted supply of medicines; (4) inappropriate and irrational use of medicines, including in animal husbandry; (5) poor infection prevention and control practices; and (6) depleted arsenals of diagnostics, medicines, and vaccines as well as insufficient research and development on new products.
Several national and international agencies have put forward guidelines on the use of antibiotics with an aim to prevent emergence of antibiotic resistant organisms. [3] Neurologists frequently care for patients with such infections. In India, many a times, intensivists, or infectious disease experts are not available to guide neurologists in the decisions regarding antibiotic use in such instances. An institutional antibiogram is often not available to them. I believe that the neurologists need to become more sensitive to the dire consequences of antimicrobial resistance. They need to participate actively in developing institutional policies in the light of the national and international guidelines in the management of infections and use of antimicrobials. They need to use their good offices to mobilize support of other health care providers and administrators to set up appropriate policies to tackle the issues related to antimicrobial resistance.
 References | |  |
| 1. | Cornaglia G, Giamarellou H, Rossolini GM. Metallo-β-lactamases: A last frontier for β-lactams? Lancet Infect Dis 2011;11:381-93. 
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| 2. | Combat antimicrobial resistance. Available from: http://www.who.int/world-health-day/2011/WHD201_FS_EN.pdf.
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| 3. | Regional strategy for prevention and containment of antimicrobial resistance. Available from: http://www.searo.who.int/LinkFiles/BCT_hlm-407.pdf. [Last accessed on 2011 May 13].
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| This article has been cited by | | 1 |
Neurologistsę role in antimicrobial resistance |
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| Mahboobi, H., Mahmoudi, F., Shahrzad, M., Khorgoei, T. | | Annals of Indian Academy of Neurology. 2012; 15(1): 68 | | [Pubmed] | |
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