The Indian Council of Medical Research advised doctors to follow a timeframe when administering antibiotics and warn against using them for ailments including viral bronchitis and low-grade fever.
According to the ICMR recommendations, antibiotics should be given for five days for skin and soft tissue infections, five days for pneumonia acquired in the community, and eight days for pneumonia received in a hospital.
“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.