India becomes largest antibiotics consumer surpassing China, US, says report

According to the India's Antimicrobial Resistance (AMR) Surveillance Network, E Coli is not the only fatal superbug skulking in your food, water and environment which, when not threatening your life, is increasing risk of complications, slowing recovery, prolonging hospital stay and pushing up treatment cost.

A bulk of hospital-acquired infections show 50% resistance to carbapenems, a powerful class of antibiotics used to treat multidrug-resistant infection.

Excessive use of antibiotics have made once easily treatable bacterial infections more difficult and often impossible to cure because bacteria evolve rapidly to evade antibiotics,leading to drug resistance.

Now,the world is running out of options,two decades ago,scientists tackled drug resistance with new and more powerful antibiotics and drug combinations.But with the last new class of antibiotics versus variations on existing ones discovered in - 1987 a few ones in development are not ready for market.

Due to the over the counter sale of antibiotics,poorly regulated private hospital sector, high rates of hospital infection,cheap antibiotics,frequent infectious disease outbreaks and rising incomes have been increasing the demand for antibiotics.

According to the study published in The Lancet, India is the world's largest consumer of antibiotics followed by China and the US, because of that India faces a major threat from superbugs.Global antibiotic use has risen 36 per cent in the decade ending 2010, with Brazil, Russia, India, China, and South Africa accounting for 76 per cent of this increase.

Excessive use is widespread not just in humans but also in the poultry industry in India, where it is used to prevent diseaseand promote growth,found in the country's largest study of drug resistance in chicken breed for meat and eggs.Chicken raisedfor both meat and eggs in 18 farms in six districts in Punjab were resistant to a range of antibiotics critical to human health,according to the study published in Environment Health Perspectives.

Antibiotic resistance was twice as high in meat-producing commercial farms compared to egg-producing farms, with multidrug-resistant E coli found in 94% ‘broiler” chicken and 60% in “layers”. Of these, 87% broilers and 42% layers had ESBL (extended spectrum B-lactamase) positive bacteria.

According to the study author Dr Ramanan Laxminarayan,director,Center for Disease Dynamics,Economics and Policy in Washington,ESBL positivity is particularly relevant as the infectious caused by these organism are more difficult to treatand are major contributors to hospital-acquired infections,which also kill people being traeted for unrelated issues.

In January this year,the US banned the use of antibiotics to help livestock gain weight and made it compulsory for meat producers to buy antibiotics only on a veterinary prescription for treating animals.Dr Ramanan also urged India to remove antibiotics from the human food chain,except to treat sick animals,or face the increasingly real prospect of a post-antibiotic world. 

India has also adopted the National Action Plan (2017-21) in April.“The objectives are of enhancing awareness, strengthening surveillance, improving rational use, reducing infections, promoting research and supporting neighbouring countries in our collective fight against infectious diseases,” said Health Minister J P Nadda. “We are ready with a blueprint. The challenge now is in its efficient implementation through a coordinated approach at all levels of use of antibiotics,” he added.

Since 2013, Indian Council of Medical Resistance's (ICMR) AMR surveillance network has networked tertiary care public and private hospitals to collect a nationally representative data on drug resistance and monitor resistance patterns across the country.“We’re running out of time.Reducing infections with the rational use of antibiotics and stopping indiscriminate use in both the public and the private sector through a nationwide dissemination campaign need to be done on a mission mode,” says Dr Kamini Walia, senior scientist and programme officer AMR, ICMR.