The presentation is solely meant for Academic purpose

I arrived on our blue planet - one dominated by its microbial life - as a blizzard tore through New York City during the winter solstice in 1945.

That final year of World War ll was coming to an auspicious close. Penicillin became readily-available in the United States and the world at large for the treatment of Gram-positive infections.

At age 5, it actually saved my life.

Frank J Bia SAJC : 2012

Klebsiella R

R

S

R

R

R

S

R

S

amikacin

cefepime

imipenem

ceftazidime

Pip-taz

cipro

meropenem

gentamicin

colistin

2010, INDIA

Klebsiella amikacin

cefepime

imipenem

ceftazidime

Pip-taz

cipro

meropenem

gentamicin

colistin

R

R

R

R

R

R

R

R

S

2012, INDIA

Klebsiella amikacin

cefepime

imipenem

ceftazidime

Pip-taz

cipro

meropenem

gentamicin

colistin

R

R

R

R

R

R

R

R

R

Changed medicine from a diagnostic profession to a treatment profession

Educating the public.

Educating the Medical Community

Educating the policy makers

Tackling the super bug problem?

A system of colour coding of third generation antibiotics and all newer molecules like Carbapenems (Ertapenem, Imipenem, Meropenem), Tigecycline, Daptomycin may be put in place restricting their access to only tertiary hospitals.

So….should ordinary Indians just die?

The National policy published in 2011 has been put on hold due to non implementability of major recommendations.1,2

1.http://ibnlive.in.com/news/antibiotic-policy-put-on-hold-

indefinitely/192878-17.html.

2. http://www.dailypioneer.com/nation/10933-lack-of-foresight-antibiotic-policy-bites-dust.html

A Road Map- To Tackle Antimicrobial Resistance August 24th 2012,Chennai

As a preconference session of CIDSCON 2012

A joint effort by Indian Medical Societies

Overseas Representatives from various continents – Herman Goossens – Dilip Nathwani – Stephan Harbarth – Arjun Sreenivas – David Paterson – Paul Thambyah

• Representatives of – Clinical Infectious Diseases Society – Association of Physicians of India – Oncology Society – Critical care Society – Indian Medical Association – Hospital infection Society – Microbiology society – Surgical society – Gynaecology Society

– World health Organisation – NABH – Indian Council of medical research – MCI – Govt.representatives

Our aim is to formulate a road map to tackle the challenge of Indian perspective of the antimicrobial

resistance problem.

India needs “An implementable antibiotic policy” and NOT “A perfect policy”

• Asking for a complete and strict antibiotic

policy in a country where there is currently no functioning antibiotic policy at all may not be an intelligent or immediately viable option.

• A strict and perfect policy will be the ideal way of killing an antibitic policy in India

• Should be liberal at first and then made stricter stepwise..

The Chennai Declaration

1. Regulate Over The Counter sale of antibiotics (OTC)

2. In- Hospital Antibiotic usage monitoring

3. Initiate measures to step up Microbiology laboratory facilities

4. National Antimicrobial Resistance Surveillance system

The Chennai Declaration

• Roles and responsibilities

– Role of Ministry of Health

– Role of Drugs Controller General of India (DCGI)

– Hospital Infection Control committee (HICC) • Antibiotic steward

• Regional (District) Infection control and antibiotic stewardship committees

• Central Task Force

The Chennai Declaration

Roles and responsibilities

• Role of Microbiology Laboratories

• Role of National Accreditation Board of Hospitals (NABH)

• Role of Medical Council of India

• Role of medical Teachers

• Role of Director of Medical Education (DME)

• Role of Directorate of Public Health (DPH)/ Directorate of Medical Services (DME)

The Chennai Declaration

• For Indians

• Of Indians

• By Indians

–To tackle the Indian perspective of the resistance problem.

Walk around feeling like a leaf. Know you could tumble any second, Then decide what to do with your time. Naomi Shihab Nye, poet

Frank J Bia SAJC : 2012