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STATUS REPORT
Year : 2011  |  Volume : 134  |  Issue : 3  |  Page : 281-294

Rationalizing antibiotic use to limit antibiotic resistance in India +


1 National Institute of Immunology, New Delhi, and Chair, GARP - India Working Group, India
2 INCLEN Trust International, New Delhi, India
3 Christian Medical College, Vellore, India
4 Veterinary College, KVAFS University, Hebbal, Bangalore, India
5 Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, India
6 Delhi Society for Promotion of Rational Use of Drugs, Delhi, India
7 National Centre for Disease Control, New Delhi, India
8 GSK Pharmaceuticals Ltd., Mumbai, India
9 University of Delhi, Delhi, India
10 Public Health Foundation of India, New Delhi, India
11 Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
12 Fortis Clinical Research Ltd., Gurgaon, India
13 Karuna Trust, Bangalore, India
14 Sir Ganga Ram Hospital, New Delhi, India
15 Center for Disease Dynamics, Economics & Policy, New Delhi & Dr Ramanan Laxminarayan, Public Health Foundation of India, India

Correspondence Address:
Ramanan Laxminarayan
PHFI, ISID campus, 4-Institutional Area, Vasant Kunj, New Delhi 110 070
India
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PMID: 21985810

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Antibiotic resistance, a global concern, is particularly pressing in developing nations, including India, where the burden of infectious disease is high and healthcare spending is low. The Global Antibiotic Resistance Partnership (GARP) was established to develop actionable policy recommendations specifically relevant to low- and middle-income countries where suboptimal access to antibiotics - not a major concern in high-income countries - is possibly as severe a problem as is the spread of resistant organisms. This report summarizes the situation as it is known regarding antibiotic use and growing resistance in India and recommends short and long term actions. Recommendations aim at (i) reducing the need for antibiotics; (ii) lowering resistance-enhancing drug pressure through improved antibiotic targeting, and (iii) eliminating antibiotic use for growth promotion in agriculture. The highest priority needs to be given to (i) national surveillance of antibiotic resistance and antibiotic use - better information to underpin decisions on standard treatment guidelines, education and other actions, as well as to monitor changes over time; (ii) increasing the use of diagnostic tests, which necessitates behavioural changes and improvements in microbiology laboratory capacity; (iii) setting up and/or strengthening infection control committees in hospitals; and (iv) restricting the use of antibiotics for non-therapeutic uses in agriculture. These interventions should help to reduce the spread of antibiotic resistance, improve public health directly, benefit the populace and reduce pressure on the healthcare system. Finally, increasing the types and coverage of childhood vaccines offered by the government would reduce the disease burden enormously and spare antibiotics.


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