Antibiotic misuse rampant in India, 0-4 years age group worst hit: Study

Inappropriate prescription and use of antibiotics is often the major source of antimicrobial resistance that is a growing concern not just in India but also globally.

Antibiotic misuse is rampant in the private sector in India, largely between the age group of 0-4 years, a new study has found.

Antibiotic misuse is rampant in the private sector in India. (Shutterstock Photo)

Inappropriate prescription and use of antibiotics is often the major source of antimicrobial resistance that is a growing concern not just in India but also globally.

Nearly 519 million antibiotic prescriptions were dispensed in 2014, translating to 412 prescriptions per 1,000 population annually, shows the first ever country level estimates of antibiotic prescription by antibiotic classes, age groups, and disease conditions that was published on Wednesday in medical journal PLOS One.

The key objective of this research was to generate new evidence on outpatient antibiotic prescription rate and patterns in the private sector in India, as the country is among the highest antibiotic users.

“Antibiotic use is generally influenced by the prescription pattern, and it’s very clear that whatever is being prescribed is largely unnecessary. Why should antibiotic be prescribed for a simple cold? ” says Dr Sakthivel Selvaraj, director, health economics, financing and policy, Public Health Foundation of India.

The bigger problem, however, is prescribing third or fourth line antibiotics. “These antibiotics are meant for treating serious infections, but because of high misuse these drugs don’t work when needed. Patients are being lost in the ICUs because there’s anti-microbial resistance due to antibiotic misuse,” he added.

The study was done by analysing 12-month (between May 2013 to April 2014), medical audit dataset from IQVIA (formerly IMS Health) an American Contract Research Organization and Pharmaceutical Service Consulting.

The antibiotic prescription rates were found to be highest for children aged 0–4 years (636 prescriptions per 1,000 persons) and lowest in the age group 10–19 years (280 prescriptions per 1,000 persons).

What is more worrisome, a majority of the antibiotic prescriptions (nearly one-fifth) were dispensed for acute upper respiratory infections (20.4%); unspecified acute lower respiratory infections (12.8%), disorders of the urinary system (6.0%), cough (4.7%) and acute nasopharynigitis (4.6%) that largely are viral diseases and self–limiting in nature.

Evidence from another study suggests that between 2000 and 2015, antibiotic consumption increased from 3.2 to 6.5 billion daily defined doses (103%).

“Antibiotic misuse is a bigger concern in hospitals and clinics in smaller towns and villages, and not that much in hospitals in big cities. There needs to strict vigil at the lower level,” said Dr RK Singal, director, department of internal medicine, BLK Hospital.