Use of new classes of antibiotics in India disproportionately high: Lancet study

The use of new classes of antibiotics in India is “disproportionately high”, a study published in the Lancet journal has underlined. About 47 per cent of the formulations – sold in 2019 – that were a part of the study were not approved by the central regulatory authorities, as per the researchers.

Between 2000 and 2010, the study highlights, citing literature, an increase of 36 per cent was registered worldwide in the human consumption of antibiotics with Brazil, Russia, India, China, and South Africa (BRICS) accounting for three-quarters of the surge. The countries, otherwise, represented 40 per cent of the global population. The researchers – at Boston University, US and Public Health Foundation of India, Delhi – have flagged “inappropriate use of antibiotics” as a “significant driver of antibiotic resistance” in India.

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.

“Although the per-capita private-sector consumption rate of antibiotics in India is relatively low compared to many countries, India consumes a large volume of broad-spectrum antibiotics that should ideally be used sparingly,” the researchers underline.

The Lancet study further highlights that Azithromycin 500mg tablet was the most consumed formulation (384 million DDDs, 7.6 percent) in the country. This was followed by cefixime 200 mg tablet (331 million DDDs, 6.5 percent).

Researchers, however, have also pointed out the limitations of the study, including the dataset covering only the private sector sales; it does “not reflect the antibiotics dispensed through the public system,” they say. Albeit, in India, according to the research, 85-90 per cent of all drug prescriptions happen in the private sector. Also the study did not review the appropriateness of prescription at the patient level.