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Thursday, 17 September 2015
Antibiotics – An Invasion in India, US and China !
Antibiotics consumption in the world is startlingly consumed
in majority by India 13 billion as against China 10 billion and USA 7 billion,
as brought by a study for the year 2010. Figures must be even more frightening
for 2015 because there is nothing to suggest a shift in trends. More
population, more infections, more drugs and inverse trends!
overprescribing antibiotics — or, prescribing it when a simpler drug would do —
is the biggest reasons for the evolution of antibiotic resistant pathogens,
Although population of the toppers is to be kept in mind
since we are dealing in absolute numbers, the consumption per person is equally
alarming. In per capita terms leader is the US with 22 units per person,
followed by India 11 and China 7.
to Mr.Ramanan Laxminarayan, research scholar and lecturer at Princeton
University, the reason behind the proliferation of antibiotics in India is
“a combination of increasing income and affordability, easy access without
a prescription, willingness of physicians to prescribe antibiotics freely,
and a high background of infections that should ideally be contained by better
sanitation and vaccination.” People forget, he said, that “antibiotics
do have side effects and […] they are less likely to work for you
when you really need them.”
The prescriptions whether private or in a research institute
or a government hospital or dispensary will have a tendency to order a heavy
prolonged dose of antibiotics to overkill the disease. A broad spectrum regimen
such as penicillin shall be adopted backed by an aggressive dosage in both
frequency and milligrams to ensure the infection disappears. Generally in the
lax atmosphere of drug law enforcement, the chemist also delivers the drugs
over the counter even without a prescription and without too much fuzz. Minimum effort. Minimum
expense. Maximum result. This psyche of the Indian populace in general
aids all such carelessly driven machanisms of the drug market too.
broad-spectrum antibiotic drugs (cephalosporins, fluoroquinolones, and
carbapenems) are sold over the counter without [the] presence of a documented
The ignorance and
callousness are at every level of the society – from care providers like
doctors, to pharmacists, lawmakers, manufacturers and [even] the consumers. In 2012, IIMAR reported that the Medical Council
of India (MCI) had received 702 complaints of such over-prescription in
2011-12, of which 343 were referred to state medical councils.
“In 2010-11, MCI received 824 such complaints, following which it
cancelled the registration of 10 doctors and warned four others,” IIMAR
According to a senior Indian pharmaceutical controlling agency, “Chemist
and [drug] associations are not interested in curbing their volume of business
and the [pharmaceutical] industry is also silent for the sake of their
to the consulting firm Deloitte,
pharmaceutical sales in India stood at 22.6 billion dollars in 2012, with a
predicted riseto 23.6 billion in
2013. Sales are expected to touch 27 billion by 2016.
The companies developing the drugs have a high level of
contact through medical representatives introducing newer brands and creating
aggressive awareness, encouraging the prescribers and sellers both to be adventurous
too ! Currently there is no oversight on appropriate prescribing. Who cares for
the side effects ! Another disease developing could be treated with another
regimen of drugs ! As frank Zappa says “another day another sausage”.
The lethal bacteria are starting to have the last laugh. This
situation is caused by prolonged use of a particular drug or a family of drugs.
This is apart from the side effects that these modern scientifically developed
drugs carry with them. Mostly hit organs in general always include the poor
liver and the kidneys.
According to a report on world’s anitibiotic report 2015,
being released by Washington based Centre for Disease Dynamics,Economics and
Policies (CDDEP), bacteria strain “Kleibsiella peneumoniae” has for example,
assumed dangerous levels of resistance towards even last resort antibiotic
class- the Carbapenems. In India it is
57% in 2014, increasing from 29%. In Europe the resistance level is below 5%. To class III generation Cephalosporins, the
bacteria strain Keibsiella is 80% resistant, to flouroquinolones 73% and 63% to
aminoglycosides. Carbapenems antibiotic class is meant to be used for the most
extreme circumstances and as a last resort, only when the patient’s life is in
danger and no other treatment will cure the infection.
India has recorded a resistance level of over 80% for 3
different drug classes in the case of the deadly E coli virus, which causes
diseases of the intestines such as severe diarrhoea, abdominal cramps and food
a country like India with limited healthcare facilities and adoctor patient ratioof one doctor to every 1,700 people, as well as 29
percent of the population languishing below the poverty line, the emergence of
super bugs could be disastrous, experts say. Infections that
could be treated in a week or two in Europe could take very long for treatment
in India and / or become life threatening!
India, with a diverse patient profile and a mostly
unregulated healthcare system, was late to adopt the new protocol for rational
use of antibiotics in 2011 and other remedial measures laid out by the World
Health Organization (WHO).
say That there should be “antibiotic
protocols for all hospital, clinics and dispensaries and this should be
displayed in each healthcare-providing agency [and] institution. There
should be statutory warnings on each pack of antibiotics, highlighting the
hazards of misuse.”
“Time has come to raise [our] voices against the irrational use of
Mcrobes They’re invisible. They’re everywhere and they rule.