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Improving antimicrobial stewardship and surveillance: the Chennai Declaration

BMJ 2013; 346 doi: (Published 28 January 2013) Cite this as: BMJ 2013;346:f591
  1. Susan Hopkins, consultant in infectious diseases and microbiology
  1. 1Royal Free London NHS Foundation Trust, London NW3 2QG, UK
  1. susanhopkins{at}

A landmark step towards combating the spread of antimicrobial resistance in India and worldwide

In December 2012 Indian doctors from all medical specialties published the Chennai Declaration in the Indian Journal of Cancer.1 The declaration documents the outcomes of the successful roadmap meeting in August 2012, led by Abdul Ghafur. At this meeting, Indian medical societies, the World Health Organization, and European and US experts came together to develop recommendations for combating the spread of antimicrobial resistance in India and improving antimicrobial stewardship across the healthcare economy in India.

India has an estimated population of more than 1.2 billion people, with more than 20 000 hospitals and more than 750 000 doctors. A large repeated survey in New Delhi showed that, when prescribing antibiotics, private clinics and pharmacies more often prescribed cephalosporins, whereas public clinics more often prescribed penicillin.2 In addition, a recent study found that more than half of rural and urban pharmacists dispensed antibiotics without a doctor’s prescription to people who presented with clinical symptoms to pharmacies.3 However, the selling of unprescribed antibiotics is not a …

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