India draws a red line under antibiotic misuseBMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1202 (Published 29 February 2016) Cite this as: BMJ 2016;352:i1202
All rapid responses
India has one of the highest rates of antibiotic resistance in the world and recent report showed the inappropriate and irrational use of antimicrobial agents against these diseases, which led to increase in development of antimicrobial resistance. 
Antimicrobial resistance is an important concern for the public health authorities at global level. However, in developing countries like India, recent hospital and some community based data showed increase in burden of antimicrobial resistance. challenges associated with controlling antibiotic resistance, particularly in India, are many and multifaceted. On one hand, antibiotics are necessary in many life-threatening cases. On the other hand, overuse of antibiotics can be disastrous in the long run. Hence, judicious use of antibiotics is required, but acceptable strategies to achieve this goal and to address the challenges must be devised and communicated. The public’s lack of knowledge about the (in)appropriate use of antibiotics. Another major challenge is the absence of a good monitoring or surveillance system for prescriptions. Doctors prescribing antibiotics to any patients with a fever, taking it as a sign of bacterial infection. Standard treatment guidelines (STG) have been formulated in many developing countries, But in India still we don’t have standard and uniform guidelines. Stressing on limiting the use of antibiotics through improved water, sanitation and immunization. surveillance alone is not enough. The key is preventing intake of antibiotics in cases where they are not needed.
With less antibiotic use, antibiotic effectiveness is maintained for a longer period. Two basic approaches are available to slow the spread of antibiotic resistance – better targeting of antibiotics to needy person and routine vaccination against pneumonia and H. influenza B virus. Several measures can be implemented in hospitals to reduce the spread of infections, such as hand washing, isolation rooms, and use of gloves, gowns, etc. in-service training for physicians to improve prescribing behavior. Hospital infection control practices in the country also vary widely and fail to prevent the spread of bacterial disease within some facilities. This leads to increased antibiotic use, which increases the selection pressure for resistance on bacteria.
Administration of broad spectrum antibiotics as an empirical therapy to the outpatients is another factor that leads to emergence of resistant strains. Prescription of antibiotics by the doctors according to patient needs without any indications and involvement of pharmacists in direct sale of drugs to patients increase the problem of antimicrobial resistance.
. World Health Organization. Prevention and Containment of Antimicrobial resistance. [Last accessed on 2012 Mar 18].
Competing interests: No competing interests