Q: How do you look at the growing threat of anti-microbial resistance? It is really as alarming as perceived?

Antimicrobial resistance till date is most often associated with nosocomial infections (hospital based infections), and reports on these are limited in India. But there have been reports on emergence of superbug, NDM-1 which in itself is a disaster as it is resistant to even high-end drugs like carbapenems.

We being a private diagnostic setup and based on our internal data, would be considered as community acquired AMR data also seems worrisome. High level and continuously increasing levels of resistance has been noted for most of the gram negative and gram positive organisms. Yes, such data hints at the seriousness of the issue and should be considered as a threat. 

Q: What are the factors that are responsible for it? Are there any remedial measures?

Factors are multi-rationale include the inappropriate use or unregulated use of high-end antibiotics in private practice. Besides that the patients discontinuing therapy midway i.e. not completing revommended treatment duration.

In such cases, the bug manipilates in such a way such that it overcomes the antibiotic effect (a phenomenon called as acquired drug resistance). Therefore patients should stop taking such decisions without consultation with their doctors.
Remedies for both these are:

Doctors need to go in for lab based antimicrobial susceptibility testing so as to avoid prescribing high end drugs. Empirical therapy with high successful treatment rates would be encouraging for now but in the long run the clinicians would have no effective drugs left to treat with.

Q: Shouldn't the government improve regulatory scenario vis a vis prescriptions and sale of antibiotics? Can't it run a broader awareness programme on the issue?

Stringent regulations to control over the counter sale of drugs have been under the governmental agenda over a long time. But immediate control and regulation seems difficult. Also the influence, role and reliability on private sector doctors needs to be taken into consideration to effectively lay down such regulations.

Q: What is the way forward so as to maintain the balance between overexposure and dire need? How can companies play a role?

Companies would be producing drugs and selling them since there is a need.
Doctors are the best to decide and differentiate between the true need and estimate the chances of overexposure.

While drug manufacturing companies can only be regulated in the presence of released governmental ordinance only. For eg. The recent pricing policy regulation on certain essential drugs for treatment of certain disease conditions like diabetes cancer which have badly hit the society.