Pune: At the prestigious 13th Annual International Best of Brussels Symposium on Intensive Care & Emergency Medicine held in Pune, leading experts from the country emphasized on the growing prevalence of complicated UTI and AMR in India, highlighting the need for effective treatment options. While people have been advised on limiting irrational use of antibiotics, experts Dr Kapil Zirpe, Dr Shirish Prayag, Dr Subhal Dixit, Dr Deepak Govil, and Dr Balaji during the press conference, opined that the issue needs to be effectively addressed through a multi-faceted approach and integrated strategies.
On the burden of Complicated UTI in India, Dr. Shirish Prayag, Organizing Chairperson of Best of Brussels Symposium said, “Complicated Urinary Tract infections (cUTIs) are the most common bacterial infections in India. Bacterial AMR is estimated to have caused or contributed to 49.5 lakh deaths worldwide and is directly responsible for 12.7 lakh deaths, according to the World Health Organization (WHO) data. Escherichia coli and Klebsiella pneumoniae are the most common causes for Complicated UTI. Patients with Complicated Urinary Tract Infections require surgeries, renal replacement, utmost intensive care in ICU and sometimes ventilation. With the rising prevalence of AMR, treating complicated UTI is becoming extremely challenging, thus requiring longer hospital stays.”
He further added,” We need to find new antibiotics. The biggest cause of AMR is the misuse of antibiotics. Antibiotics should be given on time by experts, without delay or confusion. In complicated cases, urine should be cultured, germs should be grown in the lab and tested with different antibiotics to find out which one works best. That specific antibiotic should be used.”
Highlighting the gap in MBBS education in India, Dr Prayag said, “The MBBS course should be upgraded regularly to include current AMR knowledge. Resistance patterns are different in each region — what’s found in Vellore may not be the same as Pune or Delhi. So, new doctors must learn about local resistance and sensitivities. The government must strictly monitor antibiotic sales.
Emphasizing on the rising resistance levels, Dr. Kapil Zirpe, Org. Secretary of Best of Brussels Symposium said, ““When E coli and other pathogens become resistant to anti-infectives like carbapenem, it is termed as carbapenem resistant Enterobacterales (CRE). In India, mortality associated with CRE infections is as high as 20% to 54.3%, thus underscoring the need for newer treatment options.
Dr. Subhal Dixit, Jt. Org. Secretary of Best of Brussels symposium said, “Increasing resistance complicates treatment, making outcomes uncertain, even in simple cystitis. Antibiotics should be started only after proper collection of culture, along with the antibiogram schedule showing the exact sensitivity pattern and MIC concentration. We have awareness programs running in the community as well as in hospitals, but training programs are also needed. Antibiotics should always be used cautiously, only with a proper prescription, and strictly based on a culture sensitivity–guided protocol”3
Dr. Deepak Govil, Director – Critical Care Medicine, Medanta Institute of Critical Care and Anaesthesiology said, “Future research should also be conducted to enable targeted antimicrobial therapy, to both tackle the rise of AMR as well as the tackle the rising prevalence of Complicated UTI. A multifaceted approach is imperative for tackling AMR effectively in India. This involves increased awareness, novel treatment options, improving hygiene, and addressing the antibiotic resistance issue holistically.”4
Dr. V Balaji, Professor, Clinical Microbiology, CMC Vellore and Key member, INSAR network (Supported by WHO-SEARO and ICMR) said, “We have observed significant link between of Antimicrobial Resistance (AMR) on the treatment of Complicated UTI. Till now, no new drug has ever been discovered in India, whether it’s for cancer, hypertension, diabetes, or even antibiotics. But for the first time, a medical chemist from Chennai has discovered a new antibiotic called Cefepime Enmetazobactam. This is a big achievement because usually, when a drug is discovered abroad, it takes 5–6 years to reach India. First, their own demand is fulfilled, and then it’s exported to us. And even when it comes to India, it’s 3–5 times more expensive. But this time, since the drug is made in India, it has been released here first, and it’s available at one-tenth of the cost. It’s highly effective and affordable, especially for treating complicated urinary tract infections. This is truly a remarkable and positive step that happened in the past year, and it’s something we should all be proud of.”
More than 700 critical care doctors attended the 13th edition of Best of Brussels conference in Pune.
