Are antibiotics over-prescribed in India?
Context:
Recently, the National Centre for Disease Control (NCDC) conducted a survey of approximately 10,000 hospital patients which revealed a shocking data that nearly half of them were prescribed antibiotics for preventive rather than treatment purposes.
- The survey, conducted across 20 tertiary care institutes in 15 States and two Union Territories between November 2021 and April 2022, indicated that 55% of patients received antibiotics as a preventive measure, while only 45% were prescribed antibiotics for actual infection treatment.
- Moreover, a mere 6% received antibiotics after the identification of specific bacteria.
Relevance:
GS-02 (Health)
Mains Question:
Analyze the factors contributing to the over-prescription of antibiotics in India and discuss the immediate threats posed by antibiotic resistance. Evaluate the effectiveness of existing government measures in controlling antimicrobial resistance (AMR). (250 words)
Dimensions of the Article:
- Antimicrobial Resistance (AMR) and its Causes
- Importance of Judicial Use of Antibiotics and Immediate Threats
- Addressing Antibiotic Misuse and National Policies
Antimicrobial Resistance (AMR) and its Causes:
- Definition: It referes to the resistance of micro-organisms to antimicrobial agents they were initially sensitive to.
- Concern: Multiple bacteria, such as E. coli, Klebsiella, Acinetobacter, Staphylococcus aureus, and enterococcus in India, have developed resistance to some of the latest antibiotics, leading to poorer health outcomes for patients.
- Causes: Inappropriate use of antibiotics in non-bacterial infections, lack of rapid diagnostic facilities, insufficient training in antibiotic selection, and inadequate monitoring of AMR contribute to the problem. The pharmaceutical industry’s incentivization of prescribing practices also plays a role.
Importance of Judicial Use of Antibiotics and Immediate Threats:
- Immediate Threat: Increased antibiotic resistance poses a significant immediate threat, leading to negative health outcomes. The survey demonstrated high resistance levels, especially among patients with E. coli or Klebsiella infections.
- Root Causes: Overcrowded hospitals, limited access to rapid diagnostics, and a lack of laboratories contribute to over-prescription. Antibiotics become a more convenient and cost-effective option for doctors and patients facing time constraints and financial limitations.
Addressing Antibiotic Misuse and National Policies:
- Standardization: While guidelines exist, the challenge lies in diagnosing bacterial infections accurately. Access to rapid diagnostics and a robust laboratory network is crucial.
- Government Measures: The Indian government has implemented measures to control AMR, such as banning over-the-counter use of certain antibiotics. However, challenges persist in implementing and enforcing these measures.
- Recommendations: Restricting access to reserve antibiotics, improving public health systems, and strengthening the delivery of public health services are essential to curbing the rise of AMR.
Conclusion:
The overuse of antibiotics for preventive rather than curative purposes raises concerns about antibiotic resistance in India. Addressing this issue requires a comprehensive approach, including improved diagnostic facilities, strengthened public health systems, and effective implementation of existing guidelines and policies.
