MUMBAI: A 2016 World Health Organisation (WHO) study had estimated that seven lakh deaths across the world every year could be attributed to antimicrobial resistance and the toll could rise to 10 million in 30-odd years if no corrective measures are taken.On the bright side, there is a slow but clear change in the prescribing habits of doctors across the country. Experts, though, fear that this could be a case of too little, too late.WHO observes an antimicrobial resistance awareness week to focus on this problem. The Indian Council for Medical Research (ICMR), too, started a pilot project a couple of years ago in which doctors of Mumbai’s Hinduja Hospital and five others in Delhi, Chennai and Kolkata were told to provide a “justification” within two days of prescribing restricted antibiotics. “We do this in a few chosen hospitals across the country so that we can frame guidelines as per the feedback,” said ICMR’s Dr Kamini Walia. She wants to ensure reduction in the use of broad spectrum antibiotics and boost the use of targeted antibiotics that work on specific organisms.The Kochi hospital, Amrita Institute of Medical Sciences, started its antimicrobial stewardship programme two years ago to ensure appropriate medicines and published its “positive” findings in Oxford University Press’s Open Forum Infectious Diseases journal earlier this month. Dr Sanjeev Singh, in charge of the hospital’s programme, said it has not only cut the use of restricted antibiotics by 86% but also reduced deaths by 24% and saved Rs 2.3 crore per year. Prescribing doctors have to give a justification within two days for giving the patient the drug. “If a justification is not sent, we advise discontinuation of the medicine,” he told TOI.It is estimated that every year, 58,000 neonates die due to sepsis caused by resistance to antibiotics. “We have overused them so much that nothing much is left,” said Dr Camilla Rodrigues who heads microbiology department at Hinduja Hospital, Mahim. A senior doctor in infection control said usually the microbiology department starts noticing resistance patterns but cannot independently bring about change in a consultant’s prescribing habits. ICMR’s Dr Walia said, “If doctors realize their treatment is being monitored, they may be more prudent in prescription.” But doctors face pressure from patients too. “A study showed that 70% times a patient initiates use of antibiotics,” said Dr Singh.

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