Long before superbug report, WHO warned India

With the Lancet study ringing alarm bells on anti-microbial resistance and global health experts gathering in Bangkok to discuss the drug-resistant 'superbug', it has now been pointed out that WHO had last year itself found excessive rates of antibiotic prescriptions and resistance developed to them by patients in India, based on a study conducted between 2002 and 2006.

Titled "Community based Surveillance of Antimicrobial use and Resistance in Resource Constrained Settings", the study examined trends of antibiotic use in India and South Africa. Data was collected between 2002 and 2006 in Delhi, Mumbai and Vellore, and in Durban and Brits in South Africa.

The study found that "resistance to Fluoroquinolones and third generation Cephalosporins was present in all areas, though the rates seemed to be much higher in India". Fluoroquinolones are used to treat urinary tract infections, gastrointestinal tract infections, skin and soft tissue infections and for some respiratory infections. Cephalosporins are used for respiratory tract infections such as pneumonia and bronchitis.

While the over-the-counter sales of antibiotics stood at 11.8 per cent in Durban, Mumbai reported 26.6 per cent and Delhi stood at 21 per cent meaning these percentages of antibiotics were sold without prescriptions. Surprisingly though, Vellore, for long a premier centre for healthcare in south India and considered conservative in terms of antibiotic prescriptions by doctors, was way ahead at 34.9 per cent.

Mumbai had the highest prescriptions of antibiotics with 48.6 per cent of all drugs prescribed at public hospitals being antibiotics while the number was 51.2 per cent for those by private doctors.

The study found that although Mumbai reported the highest rate of antibiotic prescriptions, Delhi was way ahead when it came to population resistant to the drugs. For instance, the study tested the efficacy of antibiotics Ampicillin, Gentamycin and Nitrofurantoin in treating E Coli infections.

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