India’s drive on AMR: No results yet

At a time when India is battling with increased antimicrobial resistance (AMR) cases pushed by irrational use of antibiotics by healthcare practitioners and the uninformed public, a study published in the latest issue of the Current Science journal has called for sounding the alarm and educate each citizen about the scope and threat of the menace.

AMR occurs when microorganisms such as bacteria, viruses, fungi and parasites change in ways that render the medications usually used to cure the infections they cause ineffective. It is rapidly spreading and has been identified as a major global threat by WHO.

The study also found that India’s Red Line campaign on antibiotics to curb the AMR menace is yet to deliver results. Titled ‘Knowledge, attitude and practice of antibiotic use and antimicrobial resistance: a study post the ‘Red Line’ initiative’  the survey found that just forty seven per cent of the people surveyed were unaware of the differences between over-the-counter (OTC) drugs and antibiotics while one in four believes that dose-skipping does not contribute to AMR.

One in ten tends to self-medicate while one in five bought medicines without prescription or started an antibiotic course by calling a doctor, noted the scientists Deepanwita Banerjee and Anu Raghunathan from Chemical Engineering Division of the Pune based National Chemical Laboratory, a lab of the Council of Scientific and Industrial Research (CSIR).

They also observed that even educated respondents were unaware about the harmful impact of AMR. Of the 504 respondents, 15 individuals thought the Red Line on the medicine strip or package had no purpose and among them 11 were postgraduates.

Overall, 63 per cent respondents were unaware that the Red Line indicated prescription drugs and this included 71 per cent undergraduates, 58.5 per cent graduates and 55 per cent postgraduates.

What’s worse, 31 per cent were unaware that bacterial infection was not the cause for common cold and cough which included 28 per cent of postgraduates and 38 per cent graduates. Almost half the respondents (47 per cent) were unaware that antibiotics could not cure viral infections but only bacterial infection.

The Red Line was not identified by a majority of the population and neither could they identify the global threat posed by AMR. One in five believed antibiotic resistance was not a serious issue. One in four individuals stopped taking the antibiotics once they felt better. One in ten people selfmedicated on a regular basis; including one in five undergraduate and one in seven graduates.

AMR is of particular concern in developing nations, including India, where the burden of infectious diseases is high and healthcare spending is low. As per a report in The Lancet infectious Diseases journal in 2014, India consumed a whopping 13 billion units of antibiotics in 2010 while an article ‘Antibiotic Resistance in India: Drivers and Opportunities for Action’ released by PLOS Medicine in March 2016 said that AMR is a global threat but the situation in India is largely alarming.

For AMR containment, the Union Health Ministry has launched the National Programme that include AMR surveillance with a network of 10 laboratories across the country. The researchers said that interventions and awareness campaigns should not be only educational but multipronged to tackle the serious societal issue of antibiotic resistance within the society.