PRIME Minister Narendra Modi’s call to check the indiscriminate use of antibiotics has been lauded by health experts who said that his message drew attention to a major health concern of antimicrobial resistance (AMR) that the country is presently facing and called for regulating over-the-counter sale of such drugs. AMR occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines, according to WHO. As a result of drug resistance, antibiotics become ineffective and infections become difficult or impossible to treat. In his monthly ‘Mann Ki Baat’ radio address, Prime Minister Modi on Sunday said that antibiotics are not medicines that can be taken mindlessly and urged people to take them only on the doctor’s advice.

 

He said the Indian Council of Medical Research (ICMR) recently released a report which said that antibiotics were proving ineffective against many diseases like pneumonia and UTI (Urinary Tract Infections). “This is a matter of great concern for all of us,” he said. Dr M Srinivas, Director of AIIMS-Delhi, underlined that antibiotics should be consumed only when prescribed by doctors and for the exact duration. “Indiscriminate use of antibiotics will lead to resistance, and if the infection increases, there will be no reserved drugs left to use. The AIIMS has taken the leadership role in this matter... We have SoPs and hospital infection control systems and are creating awareness about the issue,” he said.

 

ICMR Director General Rajiv Bahl said, “PM Modi has drawn the nation’s attention to a serious issue. Overuse or irrational use of antibiotics for infections like pneumonia can lead to resistance, making them less effective. Antibiotics should only be used when needed and prescribed by doctors,” he said. Dr Atul Gogia, senior consultant and Head of Infectious Diseases at Sir Ganga Ram Hospital, said that antimicrobial resistance is one of the greatest challenges India is currently facing. Indiscriminate use of antibiotics - unsupervised and self-medication - is leading to growing morbidity and mortality, he said. The common simple-to-treat infections are becoming increasingly difficult to treat because of the growing antimicrobial resistance, Gogia stressed. “There is a need of the hour to restrict over-the-counter sale of antibiotics as well as restrictions on their use in animals. Ensuring supervised antibiotic use in proper dosage and duration is the need of the hour to prevent further aggravation in the AMR situation,” he said.

 

The early involvement of physicians and infectious disease doctors for proper implementation of the guidelines is very essential to prevent the onslaught of AMR, he added. India, bearing a silent and large pandemic in terms of high burden of infectious diseases, with UTI and pneumonia being the major ones, easy over-the-counter availability of antibiotics, irrational prescribing, and incomplete treatment courses have accelerated resistance, said Dr Neha Rastogi, Senior Consultant-Infectious Diseases, Fortis Gurugram. “With the strategy to empower the community as a modality to combat antimicrobial resistance, Prime Minister Narendera Modi emphasised on mass awareness,” she said. Massive impact of behavioural change, better diagnostics alongside stringent regulation and implementation of national policies on controlling AMR are needed.

 

“Prevention of infections - vaccination, sanitation and environmental factors; pre-empting - early and improved affordable diagnostics, avoidance of self-medication, right dose right duration protocol are key pillars to build and sustain the drive against antimicrobial resistance,” Rastogi said. Dr Manisha Arora, Director of Internal Medicine at CK Birla Hospital, Delhi, said that antibiotic resistance has emerged as one of the most serious global public health crises. While it is a worldwide concern, India is among the countries most severely affected due to the widespread misuse and overuse of antibiotics, she said. Studies suggest that nearly 50-70 per cent of antibiotic use in India is inappropriate, she said.

 

According to the World Health Organisation (WHO), the rise of drug-resistant “superbugs” is alarming, with antimicrobial resistance currently responsible for approximately 700,000 deaths each year globally. If left unchecked, this number could rise dramatically to 10 million deaths annually by 2050, surpassing cancer as a leading cause of mortality. “In India, the situation is further worsened by self-medication and the easy availability of antibiotics without a prescription. This is a major concern and calls for stricter regulation and enforcement. “Antibiotics should only be taken when prescribed by a qualified healthcare professional. In parallel, strengthening infection prevention and control measures, along with increasing public awareness and education on responsible antibiotic use, is critical to tackling this growing threat,” Dr Arora said.