THE Indian Council of Medical Research has issued guidelines warning against the use of antibiotics for conditions such as low-grade fever and viral bronchitis while advising doctors to follow a timeline while prescribing them.

The ICMR guidelines stated that antibiotics should be prescribed for a duration of five days for skin and soft tissue infections, five days in case of community-acquired pneumonia and eight days for hospital-acquired pneumonia.

“A clinical diagnosis most often helps us predict causative pathogens fitting into a clinical syndrome which would tailor the correct antibiotic rather than blindly relying on fever, procalcitonin levels, WBC counts, cultures or radiology to make a diagnosis of infection,” the guidelines said. It stated limiting empiric antibiotic therapy to seriously ill patients.

Generally, empiric antibiotic therapy is only recommended for a select group of patients suffering from severe sepsis and septic shock, community-acquired pneumonia, ventilator-associated pneumonia and necrotizing fasciitis. Hence, it is important to start smart and then focus, i.E., evaluate if empiric therapy can be justified or de-escalated and then make a plan with regard to the duration of therapy, the guidelines said.

An ICMR survey conducted between January 1 and December 31, 2021 had suggested that a big chunk of patients in India may no longer benefit from the use of carbapenem, a powerful antibiotic administered mainly in

ICU settings for the treatment of pneumonia and septicemia, etc., as they have developed anti-microbial resistance to it. The analysis of the data pointed towards a sustained increase in drug-resistant pathogens, resulting in difficulty to treat certain infections with the available medicines.

Resistance to Imipenem, which is used to treat infections caused by E coli bacteria, increased from 14 per cent in 2016 to 36 per cent in 2021.