The Lancet report says Indians consume antibiotics at an alarmingly high rate: Basics Explained

The research, conducted by the Lancet Regional Health-Southeast Asia believes that India has a significantly large consumer base of antibiotics, however, the country does not have any formal system of antibiotic surveillance like in the west. The Lancet study also found out that Azithromycin 500mg tablet was the most consumed antibiotic formulation (7.6 per cent) in India, followed by cefixime 200 mg tablet (6.5 per cent).

This inappropriate usage of antibiotics is also a major cause of drug resistance as seen in many people.


Since their discovery, antibiotics have served as the cornerstone of modern medicine. However, the persistent overuse and misuse of antibiotics in human and animal health have encouraged the emergence and spread of antibiotic resistance, which occurs when microbes, such as bacteria, become resistant to the drugs used to treat them.

                        Antibiotic resistance happens when germs like bacteria and fungi develop the ability to defeat the drugs designed to kill them. That means the germs are not killed and continue to grow.

               Antibiotic resistance does not mean the body is becoming resistant to antibiotics; it is that bacteria have become resistant to the antibiotics designed to kill them.

                             As a result, standard medical treatments become ineffective and infections persist and may spread to others. Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”. This makes infections virtually untreatable, taking us back to the pre-antibiotic era.

                                While AMR to some extent is a natural phenomenon, certain human actions accelerate this process of increasing resistance. The single most powerful contributor to resistance is the global unrestrained use of antibiotics. This includes their underuse, overuse and misuse in both human and animal health (food animals and companion animals) and in agriculture.

      An effective way of preventing antibiotic resistance is by using antibiotics only when they are prescribed by doctors. The first antibiotic was penicillin, discovered by Alexander Fleming.

                         According to a 2016 PLOS Medicine paper, 416 of every 100,000 Indians die of infectious diseases each year. This is more than twice the U.S.’s crude infectious-disease mortality-rate in the 1940s, when antibiotics were first used there. If these miracle drugs stop working, no one will be hit harder than India.

                            Three major sources of resistance: overuse of antibiotics by human beings;

overuse in the veterinary sector;

and environmental antibiotic contamination due to pharmaceutical and hospital discharge.

                              To tackle the first source, India classified important antibiotics under Schedule H1 of the Drugs and Cosmetics Rules 1945, so that they couldn’t be sold without prescriptions. Still, Schedule H1 drugs are freely available in pharmacies, with state drug-controllers unable to enforce the law widely.

                            As far as veterinary use goes, India’s 2017 National Action Plan on Antimicrobial Resistance did talk about restricting antibiotic use as growth promoters. Sadly, no progress has been made on this front yet, allowing companies to sell last-resort drugs to farmers over the counter.

                               The 2017 document also spoke about regulating antibiotics levels in discharge from pharmaceutical firms has been pumping massive amounts of antibiotics into local lakes, rivers and sewers. This has led to an explosion in resistance genes in these waterbodies. Still, India is yet to introduce standards for antibiotics in waste water, which means antibiotic discharge in sewage is not even being monitored regularly. As the country takes its time to formulate regulations, the toll from antibiotic-misuse is growing at an alarming rate. According to a 2013 estimate, around 58,000 newborns die in India each year due to sepsis from resistant bacteria.


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