News: A Lancet Public Health study highlighted a severe imbalance in India's antibiotic consumption, showing overuse of broad-spectrum antibiotics and underuse of safer first-line drugs.

About the Study

• Analysed antibiotic use across 186 countries.
• Used the WHO AWaRe framework to estimate optimal antibiotic requirements.

Found that:

• 72% of countries use more antibiotics than necessary.
• 60% continue prescribing antibiotics no longer recommended for routine use.

WHO AWaRe Classification

• Access: First-line, narrow-spectrum antibiotics with lower resistance risk.
• Watch: Broad-spectrum antibiotics with higher resistance potential; reserved for specific severe infections.
• Reserve: Last-resort antibiotics for multidrug-resistant (MDR) infections.

Key Findings for India

• Overall Consumption:3 DID vs optimal 14.7 DID.
• Watch Group: Overused (9.3 DID vs optimal 6.0 DID).
• Access Group: Underused (4.5 DID vs optimal 7.8 DID).
• Access antibiotics account for only 27% of total use.
• WHO target: 70% Access antibiotics by 2030.
• Reserve Group: Underutilised (0.19 DID vs optimal 0.99 DID), indicating access barriers for critically ill patients.

Reasons for the Imbalance

• Unregulated over-the-counter (OTC) sale of antibiotics.
• Lack of rapid diagnostic facilities, especially in rural areas.
• Overprescription of Watch antibiotics without local antimicrobial resistance data.