Antibiotic Resistance in India: Drivers and Opportunities for Action

Laxminarayan, Ramanan; Chaudhury, R. R.

doi:10.1371/journal.pmed.1001974

Cited by 431 publications

(345 citation statements)

References 22 publications

(28 reference statements)

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“…India is one of the highest consumers of antibiotic drugs in the world. 5 Studies from different parts of India have consistently documented an ominously rising level of resistance to all the common antibiotics. 5 Over the last decade, published data have revealed doubling or even tripling of the rate of antibiotic resistance for almost all groups of clinically important pathogens.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic resistance pattern of bacteria isolated from various clinical specimens: an eastern Indian study

Paul

Ray

Sinha

et al. 2017

Int J Community Med Public Health

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Background: Resistance to antibiotics is an extremely common phenomenon in bacteria isolated from clinical material. This is a serious threat to patient care all over the world. In India, antibiotic resistance has far reaching public health consequences. In this observational study, we aimed to generate data on the prevailing pattern of antibiotic resistance from Eastern India. Methods: This was a hospital based study involving both indoor and outdoor patients. Patients with history of antibiotic use in the past 3 months were excluded. The clinical specimens (blood, urine, pus etc.) were incubated for up to 7 days under aerobic conditions before declaring them as negative. Antibiotic sensitivity was tested by modified Kirby-Bauer disc diffusion method according to CLSI guidelines. Results: There were a total of 93 specimens with the majority being blood culture (n=43) and urine (n=33). Majority (n=57; 61.3%) of isolated organisms were gram negative with E. coli predominating (n=36). Of the gram-positive isolates, Staphylococcus predominated (32 out of 36). 100% of isolates from urine were gram negative while for blood, 60% of the isolates were gram positive. Resistance to penicillin group and cotrimoxazole was up to 100% in certain species. For carbapenem group, resistance varied from 17 to 75%. Resistance to aminoglycosides was 75% in Pseudomonas and 85% in Klebsiella. Conclusions: Our study has demonstrated very high levels of resistance to different common antibiotics in different classes of bacteria. Such data can be used for antibiotic stewardship and also to formulate antibiotic use protocols.

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Section: Introductionmentioning

confidence: 99%

Antibiotic resistance pattern of bacteria isolated from various clinical specimens: an eastern Indian study

Paul

Ray

Sinha

et al. 2017

Int J Community Med Public Health

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“…Organization for Economic Co-operation and Development (OECD) report indicated that the costs of withdrawing antimicrobial growth promoters in India would be roughly US$1.1 billion (Laxminarayan and Chaudhury, 2016). In 2010, China was the largest antimicrobial consumer for livestock, and we estimate that its livestock industry will use up to 30% of the global antimicrobial production by 2030.…”

Section: Therapeutic Cost Analysismentioning

confidence: 94%

A Cross Sectional Anthropo-Clinical Study on Antimicrobials Prescription Pattern in Goat Patients at Chittagong, Bangladesh

Bhowmik¹,

Ahaduzzaman²,

Hasan³

2018

Bangl. J. Vet. Med.

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In the last three decades use of antibiotics in livestock sector has grown tremendously. The uses of these antibiotics have profound impacts on animal health, farmer income and public health. From April, 2016 to March, 2017, a hospital based retrospective study was conducted using clinical record sheet of goat patients (N=1405) at Teaching Veterinary Hospital (TVH) of Chittagong Veterinary and Animal Sciences University (CVASU), Bangladesh; to assess the groups of antimicrobials used, perception of goat owners' on antibiotics and the annual therapeutic costs for antibiotics that had been used for the treatment of goats at TVH. At TVH, the most prescribed antibiotic was streptomycin-penicillin [437 (31.10%)], whereas the least used antibiotic was tylosin [7 (0.49 %)]. From anthopo-clinical analysis, only 24% farmers said they are familiar with the term "antibiotic", but no farmer had any ideas about antimicrobial resistance and its withdrawal period. Considering the average body weight 20-30 kg of goat patients' we calculated the cost of antibiotic purchase and found the highest money (968.18-1450.04 U.S. Dollars/annum) was expenditure to purchase Gentasone plus ® (gentamicine-sulfadiazinetrimithoprime) and the lowest (5.37-8.06 USD/annum) was for tylosin. Ensuring and dissemination of proper knowledge to the farmer regarding antibiotics will prevent them from self purchase and irrational use therefore will help us to reduce the risk of antibiotic resistance in food animal.

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“…16 Moreover, per capita consumption of last resort antibiotics such as carbapenem increased to over 10 million standard units by 2010. 17 In addition to the rampant use of powerful antibiotics, India is faced with perennial public health concerns like inadequate access to toilets and poorly implemented infection-control measures in hospitals. For instance, results of a pointprevalence study conducted in a large 1800-bed tertiary care hospital in India showed an overall hospital-acquired infection (HAI) prevalence of 7 percent.…”

Section: The Growing Severity Of Problem In Indiamentioning

confidence: 99%

Antimicrobial resistance: the next BIG pandemic

Chaudhry¹,

Tomar

2017

Int J Community Med Public Health

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Pandemics have indefinitely threatened the resilience of health systems worldwide. Based on the costs inflicted by some of the deadliest pandemics in human history, economists have projected that global pandemics could cost over USD 6 trillion and generate an annual estimated loss of over USD 60 billion. While the global health community is tirelessly trying to curb the burden of premature mortality from several old and new forms of pathogens, it is now faced with the silently emerging antimicrobial resistance (AMR) pandemic that could endanger some of the most significant advances in modern medicine. Owing to rampant antibiotic consumption in India, the article shows why the country may become the ‘AMR capital of the world’. It shows how health systems may be strengthened both at the national and international levels to reduce premature mortality and morbidity attributable to AMR and pandemics.

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Antibiotic Resistance in India: Drivers and Opportunities for Action

Abstract: Ramanan Laxminarayan and Ranjit Roy Chaudhury examine the factors encouraging the emergence of antibiotic resistance in India, the implications nationally and internationally, and what might be done to help.

Cited by 431 publications

References 22 publications

Antibiotic resistance pattern of bacteria isolated from various clinical specimens: an eastern Indian study

Antibiotic resistance pattern of bacteria isolated from various clinical specimens: an eastern Indian study

A Cross Sectional Anthropo-Clinical Study on Antimicrobials Prescription Pattern in Goat Patients at Chittagong, Bangladesh

Antimicrobial resistance: the next BIG pandemic

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