Use caution while prescribing antibiotics, ICMR tells doctors

Skin and soft tissue infections should be treated with antibiotics for five days, community-acquired pneumonia should be treated for five days, and hospital-acquired pneumonia should be treated for eight days, as per the ICMR guidelines.

Empiric antibiotic treatment is often only advised for a small subset of patients who have severe sepsis, septic shock, community-acquired pneumonia, ventilator-associated pneumonia or necrotizing fasciitis. The new recommendations ask that only severe conditions should receive empiric antibiotic therapy.

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“A clinical diagnosis most often helps us predict causative pathogens fitting into a clinical syndrome which would tailor the correct antibiotic rather than blindly relying on fever, procalcitonin levels, WBC counts, cultures or radiology to make a diagnosis of infection,” the guidelines said.

A sizable percentage of Indian patients may no longer benefit from the administration of carbapenem, a strong antibiotic frequently used in ICU settings to treat conditions like pneumonia and septicemia, among others, because they have developed anti-microbial resistance to it – according to a previous ICMR study.

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Bacterium klebsiella pneumoniae showed a decline in susceptibility to certain antibiotics, going from 65% in 2016 to 45% in 2020, and then to 43% in 2021, further demonstrating the trend of decreasing bacterial susceptibility to medicines. Imipenem resistance grew from 14% in 2016 to 36% in 2021, and it is used to treat illnesses brought on by the E coli bacterium.

The analysis of the data indicated a consistent rise in pathogens that are drug-resistant, making it challenging to treat some infections with the drugs currently on the market.

(With PTI inputs)