Current Perspectives on Treatment of Gram-Positive Infections in India: What Is the Way Forward?
The emerging antimicrobial resistance leading to gram-positive infections (GPIs) is one of the major public health threats worldwide. GPIs caused by multidrug resistant bacteria can result in increased morbidity and mortality rates along with escalated treatment cost and hospitalisation stay. In Ind...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Interdisciplinary Perspectives on Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2019/7601847 |
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| author | Atul P. Kulkarni Vasant C. Nagvekar Balaji Veeraraghavan Anup R. Warrier Deepak TS Jaishid Ahdal Rishi Jain |
| author_facet | Atul P. Kulkarni Vasant C. Nagvekar Balaji Veeraraghavan Anup R. Warrier Deepak TS Jaishid Ahdal Rishi Jain |
| author_sort | Atul P. Kulkarni |
| collection | DOAJ |
| description | The emerging antimicrobial resistance leading to gram-positive infections (GPIs) is one of the major public health threats worldwide. GPIs caused by multidrug resistant bacteria can result in increased morbidity and mortality rates along with escalated treatment cost and hospitalisation stay. In India, GPIs, particularly methicillin-resistant Staphylococcus aureus (MRSA) prevalence among invasive S. aureus isolates, have been reported to increase exponentially from 29% in 2009 to 47% in 2014. Apart from MRSA, rising prevalence of vancomycin-resistant enterococci (VRE), which ranges from 1 to 9% in India, has raised concerns. Moreover, the overall mortality rate among patients with multidrug resistant GPIs in India is reported to be 10.8% and in ICU settings, the mortality rate is as high as 16%. Another challenge is the spectrum of adverse effects related to the safety and tolerability profile of the currently available drugs used against GPIs which further makes the management and treatment of these multidrug resistant organisms a complex task. Judicious prescription of antimicrobial agents, implementation of antibiotic stewardship programmes, and antibiotic policies in hospitals are essential to reduce the problem of drug-resistant infections in India. The most important step is development of newer antimicrobial agents with novel mechanisms of action and favourable pharmacokinetic profile. This review provides a synopsis about the current burden, treatment options, and the challenges faced by the clinicians in the management of GPIs such as MRSA, Quinolone-resistant Staphylococcus, VRE, and drug-resistant pneumococcus in India. |
| format | Article |
| id | doaj-art-87b989987d0c4dae8ead53cbccd7f443 |
| institution | Kabale University |
| issn | 1687-708X 1687-7098 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Interdisciplinary Perspectives on Infectious Diseases |
| spelling | doaj-art-87b989987d0c4dae8ead53cbccd7f4432025-02-03T01:12:10ZengWileyInterdisciplinary Perspectives on Infectious Diseases1687-708X1687-70982019-01-01201910.1155/2019/76018477601847Current Perspectives on Treatment of Gram-Positive Infections in India: What Is the Way Forward?Atul P. Kulkarni0Vasant C. Nagvekar1Balaji Veeraraghavan2Anup R. Warrier3Deepak TS4Jaishid Ahdal5Rishi Jain6Division of Critical Care Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra 400012, IndiaLilavati Hospital and Research Centre, Bandra Reclamation Rd, Bandra (West), Mumbai, Maharashtra 400050, IndiaDepartment of Clinical Microbiology, Christian Medical College & Hospital, Ida Scudder Road, Vellore, Tamil Nadu 632004, IndiaAster Medicity, Kuttisahib Road, Cheranalloor, South Chittoor, Kochi, Kerala 682027, IndiaDepartment of Emergency Medicine, MS Ramaiah Medical College, M S Ramaiah Nagar, Mathikere, Bengaluru, Karnataka 560054, IndiaMedical Affairs, Wockhardt Ltd., Wockhardt Towers, Bandra Kurla Complex, Mumbai, Maharashtra 400051, IndiaMedical Affairs, Wockhardt Ltd., Wockhardt Towers, Bandra Kurla Complex, Mumbai, Maharashtra 400051, IndiaThe emerging antimicrobial resistance leading to gram-positive infections (GPIs) is one of the major public health threats worldwide. GPIs caused by multidrug resistant bacteria can result in increased morbidity and mortality rates along with escalated treatment cost and hospitalisation stay. In India, GPIs, particularly methicillin-resistant Staphylococcus aureus (MRSA) prevalence among invasive S. aureus isolates, have been reported to increase exponentially from 29% in 2009 to 47% in 2014. Apart from MRSA, rising prevalence of vancomycin-resistant enterococci (VRE), which ranges from 1 to 9% in India, has raised concerns. Moreover, the overall mortality rate among patients with multidrug resistant GPIs in India is reported to be 10.8% and in ICU settings, the mortality rate is as high as 16%. Another challenge is the spectrum of adverse effects related to the safety and tolerability profile of the currently available drugs used against GPIs which further makes the management and treatment of these multidrug resistant organisms a complex task. Judicious prescription of antimicrobial agents, implementation of antibiotic stewardship programmes, and antibiotic policies in hospitals are essential to reduce the problem of drug-resistant infections in India. The most important step is development of newer antimicrobial agents with novel mechanisms of action and favourable pharmacokinetic profile. This review provides a synopsis about the current burden, treatment options, and the challenges faced by the clinicians in the management of GPIs such as MRSA, Quinolone-resistant Staphylococcus, VRE, and drug-resistant pneumococcus in India.http://dx.doi.org/10.1155/2019/7601847 |
| spellingShingle | Atul P. Kulkarni Vasant C. Nagvekar Balaji Veeraraghavan Anup R. Warrier Deepak TS Jaishid Ahdal Rishi Jain Current Perspectives on Treatment of Gram-Positive Infections in India: What Is the Way Forward? Interdisciplinary Perspectives on Infectious Diseases |
| title | Current Perspectives on Treatment of Gram-Positive Infections in India: What Is the Way Forward? |
| title_full | Current Perspectives on Treatment of Gram-Positive Infections in India: What Is the Way Forward? |
| title_fullStr | Current Perspectives on Treatment of Gram-Positive Infections in India: What Is the Way Forward? |
| title_full_unstemmed | Current Perspectives on Treatment of Gram-Positive Infections in India: What Is the Way Forward? |
| title_short | Current Perspectives on Treatment of Gram-Positive Infections in India: What Is the Way Forward? |
| title_sort | current perspectives on treatment of gram positive infections in india what is the way forward |
| url | http://dx.doi.org/10.1155/2019/7601847 |
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