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Table of Contents   
EDITORIAL COMMENTARY  
Year : 2017  |  Volume : 10  |  Issue : 6  |  Page : 1405-1406
Saving lives of mothers and newborns from infections around the time of childbirth by strengthening health sector response to the public health concern of antibiotic resistance


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai village, Chennai, Tamil Nadu, India

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Date of Web Publication11-Jan-2018
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Saving lives of mothers and newborns from infections around the time of childbirth by strengthening health sector response to the public health concern of antibiotic resistance. Ann Trop Med Public Health 2017;10:1405-6

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Saving lives of mothers and newborns from infections around the time of childbirth by strengthening health sector response to the public health concern of antibiotic resistance. Ann Trop Med Public Health [serial online] 2017 [cited 2018 May 22];10:1405-6. Available from: http://www.atmph.org/text.asp?2017/10/6/1405/222671


Dear Sir,

The problem of antibiotic resistance has emerged as one of the leading concerns endangering the lives of everyone in the modern era, and we just do not have any valid mechanism or answers to respond to the same.[1] Even though, to some extent it is true that it's a natural process; nevertheless, misuse of antibiotics in both humans and animals has expedited the entire process.[1],[2] In fact, some of the available estimates revealed that less than 50% of all the antibiotics consumed by humans are actually needed, and their usage in animals is even more needless.[1]

In addition, poor infection prevention and control activities and negligence from the health care providers also have been identified as the key determinants which have allowed the problem to increase at a rapid rate.[2] Day by day, it's becoming difficult to treat a growing number of infections and this is resulting in longer duration of stay in hospitals (which further exposes people to the risk of nosocomial infections), more direct and indirect medical expenses, an added burden on the health care delivery system, and rising rates of mortality (to all those causes which were previously preventable or curable).[1],[2],[3]

Although, no age-group is immune to the problem of antibiotic resistance, the consequences are quite serious among women and newborns around the time of birth.[2],[3] In fact, the findings of a recently released report indicated that every year in excess of 30000 women and 0.4 million newborns are losing their lives due to infection acquired near to childbirth.[3] Further, most of these deaths have been reported in low-resource settings, and the existing scenario is expected to deteriorate even further in the coming days, if no urgent corrective measures are taken.[3] Moreover, almost 50% of the newborns who die because of infections each year just do not respond to the available drugs.[3]

It is important to acknowledge that childbirth is a risky event, especially if the infants are premature (and have incompletely developed immune system), which in turn make them highly vulnerable to acquire infections.[3],[4] Further, the risk to acquire infection increases enormously in those health care establishments which are devoid of basic water, sanitation, and hygiene facilities, as observed in low-income nations.[5] At the same time, it is noteworthy that while antibiotics are indiscriminately used in a few settings, they are inadequate in other settings and people are losing lives due to lack of access to antibiotics as well.[1],[3] Moreover, from a global public health perspective, not many newer drugs have come in the market to replace the existing ones against whom resistance has been reported. In short, we are moving toward an impending disaster which is expected to result in massive sufferings and loss of lives.[1],[2]

Acknowledging the scope of the problem, a global action plan has been developed which focuses on creating awareness about the problem, improve the surveillance pertaining to reports of resistance, development of newer drugs and diagnostic tools, inculcating practices to minimize the risk of acquiring infections, optimize prescription and usage of antibiotics, and motivate policy makers to invest in health care and sanitation capacities of the nation.[1],[2],[3],[4] Further, in order to save the lives of mothers and infants from infections, it is vital to ensure that those who need life saving antibiotics should get them, while those who do not must not use or get it.[3],[5] In addition, the health care establishments should implement standardized policies to discharge mothers and new borns sooner rather than later, educate mothers about merits associated with breast feeding to improve immune system of the new born, and any use of antibiotics among them should be need-based and in correct doses.[2],[3],[4],[5]

Moreover, not much can be gained even if we succeed in developing new antibiotics, unless it is adequately supported with behaviour change (viz., vaccination, hand washing, food hygiene, etc.).[1] In addition, all the concerned stakeholders (like general public, health workers, pharmacists, policy makers, agricultural sector, and health care industry) have to be involved and all of them should work in coordination.[1],[2],[3]

To conclude, it is the responsibility of the health stakeholders to ensure that they implement strategies in such a way that all the currently available safe drugs are judiciously used, lives of mothers and newborns can be saved, and the magnitude of the problem can be reduced.

Acknowledgement

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health Organization. Antibiotic resistance-Fact sheet; 2015. Available from: http://who.int/mediacentre/factsheets/antibiotic-resistance/en/. [Last accessed on 2016 Aug 31].   Back to cited text no. 1
    
2.
Shrivastava SR, Shrivastava PS, Ramasamy J. Much more is expected from nations to counter antimicrobial resistance: World Health Organization. J Res Med Sci 2015;20:719-20.  Back to cited text no. 2
    
3.
Costello A, Peterson SS. Birth in a time of antibiotic-resistant bacteria; 2016. Available from: http://who.int/mediacentre/commentaries/antibiotic-resistant-bacteria/en/. [Last accessed on 2016 Aug 31].  Back to cited text no. 3
    
4.
Bentley J. Awareness of antibiotic resistance is important. Nurs Child Young People 2016;28:13.  Back to cited text no. 4
[PUBMED]    
5.
Bolukaoto JY, Monyama CM, Chukwu MO, Lekala SM, Nchabeleng M, Maloba MR, et al. Antibiotic resistance of Streptococcus agalactiae isolated from pregnant women in Garankuwa, South Africa. BMC Res Notes 2015;8:364.  Back to cited text no. 5
[PUBMED]    

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Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.222671

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