At 13 billion pills in a year, India tops in antibiotics use globally

India is the world's antibiotic-popping capital, recording the highest number of such pills consumed annually — 13 billion against 10 billion in China and 7 billion in the US.

As a result of such reckless use, deadly strains of lifetaking bacteria that are resistant to even the latest generation of antibiotics have been found to be rampant in India.

The first State of the World's Antibiotics report, to be released by the Washington-based Centre for Disease Dynamics, Economics and Policy (CDDEP), has found that bacteria strain Klebsiella pneumoniae's resistance to last-resort antibiotic class Carbapenems was a whopping 57% in India in 2014, up from 29% earlier.

This is a dangerous superbug whose resistance rate in Europe is below 5%.

Klebsiella's resistance to a variety of drugs is high — the bug is around 80% resistant to class III generation Cephalosporins, 73% to fluoroquinolones and 63% to aminoglycosides. For four of five drug classes tested, Klebsiella was over 60% resistant in India. With antibiotic use in creasing by 43% in India from 2000 to 2010, resistance to the deadly E Coli, which causes serious food poisoning, abdominal cramps and severe diarrhoea, too has been growing. For three different drug classes, E Coli resistance in India is currently over 80%.

R Laxminarayan, CDDEP director and report co-author said, "Rampant rise in anti biotic use poses a major threat o public health, especially when there's no oversight on appropriate prescribing".

"Carbapenem antibiotics are for use in the most dire circumstances — when someone's life is in danger and no other drug will cure the infection," said Sumanth Gandra, an infectious diseases physician,and CDDEP resident scholar.

Since their introduction into medicine in the 1940s, antibiotics have been used from treating serious infections to preventing infections in surgical patients, protecting cancer patients and people with compromised immune systems.

Now, however, once-treatable infections are becoming difficult to cure, raising costs to healthcare facilities, and patient mortality is rising.

Antibiotic resistance is a direct result of antibiotic use. The greater the volume of antibiotics used, the greater the chances that antibiotic-resistant populations of bacteria will prevail.

The report says, "Rising incomes are increasing access to antibiotics. That is saving lives but also increasing use — both appropriate and inappropriate-which in turn is driving resistance".

Experts say the Indian Council of Medical Research had begun setting up the Anti-Microbial Resistance Surveillance Network in 2011. When complete, its seven nodes will focus on diarrhea, enteric fever, sepsis, gram-positive bacteria, fungal infections and respiratory pathogens.