This is a article about Indian doctors involved in treatment of patients with severe infections.  Being a doctor myself, observed irrational use of antibiotics which made me to write this article. Until a few years ago atleast we could try our powerful antibiotics against infections but because of irrational use of antibiotics we are going to face so many problems in near future. A national resistance alert from u.k issued on jan 2009 warned of increase number of carbapenem resistant strains of enterobacteriacea being identified in u.k hospitals a significant proportion of whom had received medical treatment in india and pakisthan. This new resistance is named as "New delhi metallo 1" at the time of publication u.k identified 22 NDM-1.

             We have now data from one of our own hospitals Deshpande team in Hinduja national hospital, mumbai, have isolated 22 ndm1 enterobacteriace for just 3 months. If a single hospital can isolate  such significant number of new resistant bacteria. If data is acquired from all hospitals in india if avialable it would be shocking..............

                  Majority of indian hospitals struggle to hide their resistance statistics, we come across multi drug resistant or even pan resistant gram negative bacteria which are reported from all centers of India. We Indians are leaders in antibiotic resistance, private hospitals , nursing homes and corporate  hospitals are breeding places for the reisitance.

          When we are called to manage  severe infections, due to pan resistant bugs we do really wonder whether we are living pre-Alexander fleming years with out antibiotics and then with a shock but no surprise realise that we have reached end of antibiotic era.

         There is no restriction of usage of higher end antibiotics in India. Any doctor can prescribe or even in some areas pharmacist can dispense with out prescription Meropenam which is the higher antibiotic where ampicillin is needed.

            Choosing the right antibiotic is critical and adequate knowledge on spectrum of antibiotics is neccessary. Art of war is deception,deceiving the enemy but we decieved ourselves by underusing, misusing and overusing of antibiotics.