Tackling AMR crisis in India: Changing paradigm

Lahiry, Sandeep; Dalal, Krunal; Pawar, Ashwini; Chugh, Yashpal; Gandhi, Alap; Kotak, Bhavesh

doi:10.3126/ajms.v11i6.29427

Cited by 5 publications

(8 citation statements)

References 12 publications

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“…In April 2017, in response to this WHO initiative, 5 the Indian Ministry of Health and Family Welfare published a 5 year NAP (2017–21) on AMR outlining the priorities and implementation strategies for curbing AMR in India. 4 , 6 The first five strategic priorities of NAP-AMR are firmly aligned with the GAP on AMR and an additional sixth strategic priority highlights India’s aspirational aim to contain AMR at an international level with other countries and organizations, national disease control programmes and at a sub-national/state level through development of state action plans on AMR. 4 , 6 …”

Section: Action Plan Developmentmentioning

confidence: 99%

“… 4 , 6 The first five strategic priorities of NAP-AMR are firmly aligned with the GAP on AMR and an additional sixth strategic priority highlights India’s aspirational aim to contain AMR at an international level with other countries and organizations, national disease control programmes and at a sub-national/state level through development of state action plans on AMR. 4 , 6 …”

Section: Action Plan Developmentmentioning

confidence: 99%

“…The burden of infectious disease in India (population, as of 2022, 1 403 458 058) 7 is considered to be amongst the highest in the world and includes infections due to multiresistant pathogens. 6 In 2010, India was the world’s largest consumer of antibiotics in humans. 4 Antibiotic consumption in India is high due to: easy access to OTC medicines, self-medication based on word of mouth advice or on internet searching, non-availability or non-utilization of clinical microbiology laboratory services for cultures and antibiotic susceptibility testing (AST), variation in the approach of clinicians to antibiotic prescribing, lack of antibiotic de-escalation, regulatory issues and commercial antibiotic promotion.…”

Section: Burden Of Diseasementioning

confidence: 99%

“… 4 Antibiotic consumption in India is high due to: easy access to OTC medicines, self-medication based on word of mouth advice or on internet searching, non-availability or non-utilization of clinical microbiology laboratory services for cultures and antibiotic susceptibility testing (AST), variation in the approach of clinicians to antibiotic prescribing, lack of antibiotic de-escalation, regulatory issues and commercial antibiotic promotion. 4 , 6 Underuse of antibiotics due to lack of access to good quality and affordable antibiotics is also common in India, leading to significant mortality (particularly in paediatrics). In addition to human healthcare, antibiotics are also used in animal husbandry, fisheries (for treatment and growth promotion), as well as in agricultural sectors.…”

Section: Burden Of Diseasementioning

confidence: 99%

“…The lack of knowledge among the public is also a matter of concern regarding appropriate use of antibiotics along with poor compliance and self-medication. 6 Another factor contributing to the crisis of AMR is environmental pollution due to pharmaceutical, livestock and hospital waste. 4 , 8…”

Section: Burden Of Diseasementioning

confidence: 99%

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Country data on AMR in India in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicine and clinical outcome

Torumkuney

Poojary

Shenoy

et al. 2022

Journal of Antimicrobial Chemotherapy

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Background Antimicrobial resistance (AMR) is one of the biggest threats to global public health. Selection of resistant bacteria is driven by inappropriate use of antibiotics, amongst other factors. COVID-19 may have exacerbated AMR due to unnecessary antibiotic prescribing. Country-level knowledge is needed to understand options for action. Objectives To review the current situation with respect to AMR in India and initiatives addressing it. Identifying areas where more information is required will provide a call to action to minimize further rises in AMR and to improve patient outcomes. Methods National AMR initiatives, antibiotic use and prescribing in India, and availability of susceptibility data, in particular for the key community-acquired respiratory tract infection (CA-RTI) pathogens (Streptococcus pneumoniae and Haemophilus influenzae) were identified. National and international antibiotic prescribing guidelines for specific CA-RTIs (community-acquired pneumonia, acute otitis media and acute bacterial rhinosinusitis) commonly used locally were also reviewed, plus local antibiotic availability. Insights from a local clinician and clinical microbiologist were sought to contextualize this information. Conclusions Many initiatives have been launched since AMR was recognized as a national priority and organizations such as the Indian Academy of Paediatrics and the Global Antibiotic Resistance Partnership have worked to build awareness. The Indian Ministry of Health and Family Welfare published a 5 year national action plan on AMR. However, the burden of infectious disease and consumption of antibiotics in India is high. There have been national surveillance studies generating local data along with international studies such as Survey of Antibiotic Resistance (SOAR) and Antimicrobial Testing Leadership and Surveillance (ATLAS). For common RTIs, clinicians use a range of international and national guidelines. However, a more standardized inclusive approach to developing local guidelines, using up-to-date local surveillance data from community-acquired infections, could make guidelines more locally relevant. This would encourage more appropriate antibiotic prescribing and improve adherence. This would, in turn, potentially limit AMR development and improve patient outcomes.

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