Antibiotics overdose killing TS infants

The Special Newborn Care Units can ideally be considered as models for the entire Telangana State. More importantly, they are quite suitable for providing training to medical staff from other hospitals as well.

The UNICEF Reproductive Child Health (RCH) programme that has in place in Telangana State is designed to reduce the maternal, newborn, infant under five mortality rates from the current 29 deaths per 1000 live births and the rate of HIV infection.

Towards this, the State Government has launched India Newborn Action Plan (INAP) to reduce infant mortality rate and bringing down the number of deaths to a single digit by 2030. This effort is being carried out through various initiatives that support effective implementation of the National Health Mission (NHM).

UNICEF has collaborated with the Telangana government to set up 18 Special Newborn Care Units and 61 newborn stabilization units in public sector hospitals in Telangana to improve neonatal care at secondary and tertiary levels.

But, the special newborn care units (SNCUs) attached to government hospitals in the state have been found to be administering high doses of antibiotics to newborns-sometimes in as much as 98% cases they treated. This alarming revelation was made in the latest report by the UNICEF.

Titled 'Antibiotics usage rate across SNCUs in Telangana', the data compiled by UNICEF showed that care givers in as many as 13 out of 19 SNCUs in Telangana administered antibiotics on newborns in 55% to 98% of the cases between January 1, 2014 and December 14, 2015.

The report has warned that antibiotic resistance is a stark reality across India, including in Telangana where the challenges associated with controlling antibiotic resistance is multifaceted.

On one hand, antibiotics are necessary in many life-threatening cases while on the other, its overuse can be disastrous in the long run. Hence, judicious use of antibiotics is required, but acceptable strategies must be devised and communicated by the government.

It also cautioned that despite rapid economic growth 9,00,000 newborn children in India every year. This means more than one child dying every minute due to under-nutrition, respiratory infections, lack of immunization, overdose of antibiotics and health facilities are the underlying causes of these newborn deaths. However, most of these deaths are preventable if adequate measures have been taken by the government to ensure that every child born gets the best start in life.

For the record, 37,394 newborns were treated in SNCUs in Telangana between January 2014 and December 14, 2015. Out of these, 27,580 babies were discharged (73.8%), 3,267 died during treatment (8.7%), 3,561 were

referred to higher centres (9.5%) and 2,986 newborns left the hospital against medical advice (7.9%).But what the future holds for the 27,580 newborns discharged is anybody's guess as a majority of them were administered high doses of antibiotics by the doctors, making them prone to several complications, aver experts. Antibiotics, first used in the 1940s are certainly one of the great advances in medicine. But overdosing them has resulted in the development of resistant bacteria, that don’t respond to antibiotics that may have worked in the past.

Plus, whenever newborns given overdose of antibiotics they run the risk of side-effects, such as stomach upset and diarrhea or even an allergic reaction, noted the report. The consequences of over dose of antibiotics is that when these newborns turn one-year-old, there are chances that even minor infections leading to cough and cold can flare up into serious problems, making it life-threatening, as they would stop responding to antibiotics.

The report advised the judicious use of antibiotics on babies should be administered only where there is clinical evidence shows that the child needs it. One way to cut down on antibiotics is to ensure that health care handlers and equipment in SNUCs must be sterilized to prevent the spread of infection, which usually prompts the hospital to administer antibiotics, noted the report.

Actually, the sepsis (infection) rate in SNCUs in Telangana is just 10.8% as compared to the national average of 30%. The report says that antibiotics usage should always be on par with the sepsis rate and any use more than that may lead to what is known as antibiotic resistance, which is now a global problem.

The report also mentioned that a few SNCUs are actually following the protocol like Niloufer Hospital and the Government Maternity Hospital in Koti, where the antibiotics usage rate was found to be 30% and 13% respectively. It implies that the time has come for some sensible administration.

By G Rajendera Kumar