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Superbug demands organizational change of the healthcare system

Journal of Pharmacology and Pharmacotherapeutics
Medknow Publications
Publication Date
DOI: 10.4103/0976-500x.81915
  • Correspondence
  • Biology
  • Education
  • Medicine
  • Pharmacology
  • Political Science


Sir, The paper entitled “Emergence of a new antibiotic resistance mechanism in India, Pakistan and the UK: A molecular, biological and epidemiological study” by Kumarasamy et al[1] published in Lancet Infectious Diseases aroused a lot of controversies in media. This we believe is an eye-opening study and we urge everyone to understand the intensity of this problem, rather than blaming one another. Just stopping referrals of UK patients for treatment/surgery to India cannot be a solution for such a serious problem. Millions of foreigners travel to India and vice versa. It is not appropriate to blame any particular country. The best strategy is to be more responsible and try to overcome insufficiencies of our own health care system. Since medical tourism is emerging in other Asian countries as well, such as Thailand, Malaysia, Philippines, and Indonesia. Extending this type of studies in to these countries is equally important.[2] As physicians, we feel irrational use of antibiotics in India is an organizational problem of Indian health care system. Two important challenges are highlighted. In India Allopathic and alternative medicines are in practice. Healthcare providers might be with formal training in alternative medicine; with no formal training but recognized by the government (RMP doctor), and also with no formal qualifications or government recognition.[3] Even without formal pharmacology in the curriculum of the alternative medicine practitioners, all types of health care providers prescribe antibiotics.[4] Furthermore, to make the situation worst most of the clinics in the remote villages are run by RMP doctor (paramedics with some rudimentary training, without any type of recognized medical education). They do not even hesitate to prescribe any type of higher antibiotics;[5] the reason is simple, many of them are unaware of what an antibiotic is and what gram positive or negative microbes are. Unfortunately, about 75% of Indian population comes from remote villages. After trying all type

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