Patients are always curious and ask “doctor, why have I got infection? From where? I eat good, maintain good health?” there are no ready answers. But there are certain factors in environment, which cause infections. More infections will require more antibiotics to be used and hence make bacteria resistant and difficult to treat. In fact, this one factor can undo all the advancement of medical science and push us back by centuries to pre-antibiotic era. Not uncommonly, response to antibiotics is not good and doctors are blamed for not doing enough. It is hard for the patient to know and understand the complexity of situation.
Antibiotic resistance is the ability of a microorganism to withstand the effects of an antibiotic. Antibiotic resistance evolves naturally or could also be engineered by applying an evolutionary stress on a population. If stress (Antibiotic) is applied on bacteria, a mutation or gene is generated. In other words, evolve into highly resistance bugs because of use of antibiotics. If a bacterium carries several resistance genes, it is called multi resistant or a superbug. Antibiotic resistance is a consequence of evolution of bacteria.
The antibiotic action is an environmental pressure; those bacteria which have a mutation allowing them to survive will live on to reproduce. When these bacteria are cause of infection and severe illness, even the best medical care does not prevent death in every case.
Antimicrobial resistance is a major public health problem globally while all types of AMR are concerning, antibacterial resistance (ABR) is seen as currently posing the most serious health threat. India has some of the highest antibiotic resistance rates among bacteria that commonly cause infections in the community and healthcare facilities, shows the latest Department of Biotechnology (DBT) report. Antibiotic resistance among bacteria high in India, reveals report.
The Scoping Report on Antimicrobial Resistance in India, as it is called, was prepared for DBT and Research Councils United Kingdom (RCUK) by the Center for Disease Dynamics, Economics & Policy, India (CDDEP).The Antimicrobial resistance is spreading is popping up in India, from the fecal matter of animals to groundwater for drinking. This is a concern as microorganisms can spread from animals to people and from the environment to humans. This contamination is one of the important cause of increased infections and hence use of more antibiotics in community.
Swachh Bharat if truly applied can actually contribute and solve problem of antibiotic overuse and hence resistance to antibiotic to some extent. Garbage and undisposed poop of human and animals cause generation of infections and diseases, hence leading to increased need for antibiotics. That requires heavy use of antibiotics and consequently leads to emergence of further antibiotic resistance bacteria. This cycle of production of infections and use of antibiotics perpetuates a vicious cycle. Although as I mentioned disposal of animal waste remains a challenge for Swachh Bharat as current policies do not address this issue, which contaminates air and water sources.
Stray animals still defecate at every place. Poop of Stray dogs, cattle and pigs stays in environment and causes life threatening infections. Pet owners also do not show responsible behavior towards community in the absence of proper rules. Hundreds of diseases are described due to poor control of human animal interface. My appeal to higher authorities is to form policies and create awareness in this regards can do wonders for community acquired infections and hence tackle with menace of antibiotic resistance as well. True application of Swachh Bharat in controlling human animal interface can improve health of millions in the country.
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Swatch Bharat obstacle: declare “open defecation free zone” only if free of infectious, toxic dog & animal poop.
Evolution of Medical profession-Extinction of good doctors 
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