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Antibiotic-Resistant Infections in India Could Go Pandemic

Penicillin was the first antibiotic discovered by Alexander Fleming in 1929 and had a huge impact on the war between humans and bacteria . Since then, development and sales of antibiotics have booming .However, health officials have also been warning us for decades, that the overuse of antibiotics would eventually lead bacteria to evolve in a way that made the same very drugs useless.  Now, along with the large-scale use of antibiotics, doctors have found that bacteria have been developing resistance to antibiotics faster than new antibiotics could be developed.The is what is  called the  “antibiotic resistance genes (ARGs)”.

In August, 2010, The Lancet published an article “Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study”, which said that the researchers have found a “superbug” allowing pathogenic bacteria to become extremely powerful to resist nearly all antibiotics. Such “superbug” was likely to spread all around the world and become a serious global health problem. This strong resistance was conferred by an enzyme called “New Delhi metallo-β-lactamase 1”, which we are now known as “NDM-1”.


The Centers for Disease Control and Prevention previously estimated that two million people were sickened by resistant bacteria every year in the United States and 23,000 died as a result. But efforts to crack down on inappropriate antibiotic use in the United States and much of Europe have been successful with prescriptions dropping from 2000 to 2010. However, sales of antibiotics for rose 36 percent from 2000 to 2010, with Brazil, Russia, India, China and South Africa accounting for 76 percent of that increase.

According to articles ,researchers say that a significant share of the bacteria present in India (in its water, sewage, animals, soil and even its mothers)  are immune to almost all antibiotics. Bacteria spread easily in India because half of Indians defecate outdoors and much of the sewage by those who do use toilets is untreated. As a result, Indians have among the highest rates of bacterial infections in the world and collectively take more antibiotics which are sold over the counter here.

A big study done in India was to test residues of antibiotics in chicken – 70 chicken samples from Delhi and the National Capital Region (NCR) were tested, of which 40 per cent samples tested positive and residues of more than one of six commonly used antibiotics were found in 17 per cent samples. The results of this study points to large-scale unregulated use of antibiotics as growth promoters by the poultry industry and could be one of the reasons Indians might be developing antibiotic resistance.

Sadly, newborns in India have taken the biggest hit as they are particularly vulnerable because their fragile immune systems. As reported in the Times of India, more than 58,000 babies died last year of these infections.While that is still a fraction of the nearly 800,000 newborns who die annually in India,  paediatricians say that the rising toll of resistant infections could seriously hamper efforts to improve the country’s IMR.

“Reducing newborn deaths in India is one of the most important public health priorities in the world, and this will require treating an increasing number of neonates who have sepsis and pneumonia,” said Dr. Vinod Paul. He is the chief of paediatrics at the All India Institute of Medical Sciences . “But if resistant infections keep growing, that progress could slow, stop or even reverse itself. And that would be a disaster for not only India but the entire world” , he said in the TOI article.

Everyone is at risk in the country.  Recently, Uppalapu Shrinivas, one of India’s most famous musicians died because of an antibiotic resistant infection.

Dr. Timothy R. Walsh, a British microbiology expert, has  said situation in India was like a “tsunami of antibiotic resistance” that would affect the entire planet. Dr Walsh said the situation was due to uncontrolled antibiotic prescriptions, overcrowding, and “dreadful sanitation”.

In 2012, the Drug Controller General of India (DCGI) Dr Singh had  written to the then Union health minister to notify of a new schedule H1 in the Drugs and Cosmetics Rules for certain antibiotics so that they cannot be sold without prescription. Dr Singh had said that- important drugs that Indians are becoming resistant to or can become resistant to are being put under schedule H1. Much more needs to be done in terms of raising awareness among citizens of the dangers of overuse of antibiotics as well as training medical practitioners not to over medicate.

The World Health Assembly has now urged WHO to develop a global action plan against AMR by 2015. The plan is being organised around five main areas of concern: awareness; information on the magnitude of the problem; economic impact; rational use of antimicrobials and preventing infection. “We must act urgently. The world is heading for a post-antibiotic era which will be devastating in this age of emerging infectious diseases. If we do not use antibiotics rationally, we will lose the power to fight common infections and minor injuries. We need to step up efforts to prevent antimicrobial resistance and change how we prescribe and use antibiotics,” said Dr Poonam Khetrapal Singh, WHO regional director for South-East Asia.


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