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Antibiotics abuse: India among the worst

Global consumption of antibiotics increased by forty percent between 2000 and 2015, according to a study by researchers at the Center for Disease Dynamics, Economics and Policy, published in The Lancet Infectious Diseases.

antibiotic Image credit: Kira Garmashova / 123rf
Image credit: Kira Garmashova / 123rf

The relative consumption of “Watch” antibiotics was found to be highest in Japan, at an alarming 83 percent. India followed in as the second highest consumer at 65 percent. The World Health Organization defines the Watch antibiotics group as “antibiotics that have higher resistance potential and includes most of the highest priority agents among the Critically Important Antimicrobials for Human Medicine and/or antibiotics that are at relatively high risk of selection of bacterial resistance.” The Watch group includes 110 antibiotics, eleven of which are included on the WHO Model List of Essential Medicines as first- or second -choice treatment options for a number of infectious diseases.

Health Issues India has reported on the issue of antibiotic misuse in the past, citing a paper authored by three researchers of Gurugram-based Public Health Foundation of India (PHFI). The paper found that third and fourth line-antibiotics — used as a last resort in cases where resistance is present to more commonly used medications — are being used indiscriminately within India.

“The third line of antibiotics is to be prescribed only at hospital-level, usually in ICUs [intensive care units]; only if the severity of the infection has reached that stage. However, to our utter surprise, we found that they are being prescribed at primary care level. This is totally unscientific and unacceptable,” said Sakthivel Selvaraj, one of the authors of the paper, in an interview with Down To Earth.

India, along with other low- to middle- income countries (LMICs), are a major driving force behind the global increase in the use of antibiotics. India is the largest consumer of antibiotics in the world — driven in part by its vast population — with consumption documented to have increased by 103 percent from 2000 to 2015, the highest among all low and middle-income countries (LMICs).

It is vital that countries across the world begin to implement stricter measures in order to control antibiotic overuse. Use of second-, third- and even fourth-line antibiotics as frontline prescriptions runs the hazard of allowing antibiotic resistance to our current last lines of defence against diseases such as tuberculosis.

Resistance to these antibiotics is already being documented, highlighting that this is not a situation that can be sidelined and left to worsen. If nothing is done, we may witness bacterial strains resistant to all current treatments, representing a disease that we simply cannot cure.

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