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The Hindu
The Hindu
National
A.S. Jayanth

High antibiotic use could lead to drug resistance: study

The use of broad-spectrum antibiotics that act against a wide range of disease-causing bacteria is high in India, a research study has found.

Experts say that if a patient reports a serious infection later, these antibiotics may become ineffective as the body will have developed drug resistance.

The study titled ‘Consumption of Systemic Antibiotics in India in 2019’ was published in the Lancet Regional Health-Southeast Asia on June 22. It investigated antibiotics use in India using the World Health Organisation’s (WHO) Access, Watch, and Reserve classification of antibiotics and defined daily dose matrices. The authors are Shaffi Fazaludeen Koya, Wirtz V.J., Galea S., and Rockers P.C. of the Department of Epidemiology, Boston University School of Public Health, U.S., and Ganesh S. and Selvaraj S. of the Public Health Foundation of India.

Safety practice

Doctors use broad-spectrum antibiotics in the absence of blood, swab, sputum or urine tests as a safety practice as they do not want to miss any organism or infection in the patient. Azithromycin and Doxycycline are some of the most commonly used antibiotics that are sometimes taken even without a doctor’s prescription. They, however, act on multiple groups and strains of bacteria leading to drug resistance.

“People should not buy antibiotics without prescription. Do not force or insist your doctor to write antibiotics for every small fever or cough as most of these are viral diseases that do not need antibiotics. Ask your doctor if it is absolutely needed when you get an antibiotics prescribed,” Dr. Koya told The Hindu. The government should regulate fixed-dose combination of antibiotics which is discouraged by the WHO. Most of these combos are not approved by the Central drug regulatory body but are marketed based on the State drug authority’s approval.

The study also found that the per-capita consumption of antibiotics had been low compared to previously reported rates, Dr. Koya said.

Inappropriate use

“The overlap in regulatory powers between national and State-level agencies complicates the availability, sales, and consumption of antibiotics in the country. The study found a high volume of inappropriate use of antibiotics, including high use of WHO-discouraged formulations, besides very high use of fixed-dose combinations,” he said.

With antibiotics resistance emerging as a global public health problem, the study suggested instituting new regulations and strengthening existing ones to monitor and regulate the sale and use of antibiotics. It also sought improving access to appropriate them through the public health system.

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