A study published in the Lancet journal last week has pointed out unwise and ‘disproportionately’ high use of antibiotics which according to weekly peer-reviewed and the world’s highest-impact general medical journal drives antibiotic resistance in India.
The survey pointed out that about 47 per cent of the formulations, sold in 2019, were not even approved by the central regulatory authorities.
Between 2000 and 2010, the study highlights, citing literature, an increase of 36 per cent was registered worldwide in the human consumption of antibiotics and among them India’s share was on a higher side.
Fewer curbs on the over-counter-sales, manufacturing and marketing of many fixed-dose combinations (FDC), and overlapping of regulatory powers between the central and state agencies have been linked to these observations. During the study, data was gathered from a panel of 9,000 stockists and the World Health Organization’s AWaRe (Access, Watch, Reserve) classification and the defined daily dose (DDD) metrics was used to calculate the per-capita consumption.
In other words, it exposed challenges in tackling antimicrobial resistance in India. This practice rather assumes alarming proportions and raises safety and efficacy concerns.
In November last year a doctors’ body here had called for judicious use of antibiotics, underlining that the inappropriate use of antibiotics was responsible for alarming levels of antibiotic resistance in the valley.
According to it, two-thirds of antibiotics were ‘unnecessarily’ prescribed for infections caused by viruses or conditions that are not linked to infection at all.
Besides doctors, chemists also give antibiotics for everything from malaise, fatigue, body aches to headache, it had noted.
In fact, the doctor’s body had said that inappropriate and irrational use of antibiotics has turned Kashmir hospitals into breeding grounds for deadly bacteria that are resistant to all antibiotics. More than 80% of the bacteria are resistant even to last resort antibiotics, it had stated.
In such a scenario, the drug regulators need to devise a stricter system of controls and checks so that not only over-the-counter antibiotics and their ill-matched combinations can be prevented but also on prescriptions by some doctors for obvious ulterior motives. Both instances often lead to resistance to antibiotics which may prove more dangerous in future than they appear in contemporary times.
The Lancet survey and concerns from the concerned quarters requires thorough evaluation against present and future health problems. Perhaps a formal system of antibiotic use surveillance should be built to guide an antimicrobial stewardship program.
