From the Guidelines
The prevalence of antimicrobial resistant (AMR) pathogens in India is alarmingly high and continues to increase, with resistance rates for common bacterial pathogens often exceeding 50% for first-line antibiotics, as reported in studies such as 1 and 1.
Key Factors Contributing to AMR in India
- Inappropriate antibiotic prescribing
- Over-the-counter antibiotic availability without prescription
- Poor infection control practices in healthcare settings
- Inadequate sanitation infrastructure
- Limited surveillance systems
- The agricultural sector's extensive use of antibiotics as growth promoters
High-Risk Pathogens
- Extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae
- Carbapenem-resistant Enterobacteriaceae (CRE)
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Multidrug-resistant tuberculosis
Resistance Rates
- Resistance to carbapenems in Klebsiella pneumoniae ranges from 30-70% across different regions of India
- ESBL production in E. coli isolates often exceeds 60%
- MRSA rates in hospital settings frequently reach 40-50%
Need for Urgent Action
The situation necessitates urgent implementation of antimicrobial stewardship programs, strengthened infection control measures, improved diagnostic capabilities, and greater public awareness about appropriate antibiotic use to address this growing public health crisis, as outlined in the National Action Plan (NAP) on Antimicrobial Resistance (AMR) 2017–2021 in India 1.
From the Research
Prevalence of AMR Pathogens in India
- The prevalence of Antimicrobial Resistance (AMR) pathogens in India is a significant concern, with the country being one of the largest consumers of antibiotics in the world 2.
- According to a study published in 2022, the global burden of bacterial antimicrobial resistance is estimated to be around 4.95 million deaths associated with bacterial AMR, including 1.27 million deaths attributable to bacterial AMR 3.
- India is one of the countries with a high burden of AMR, with a significant number of deaths attributed to resistant infections 4.
- The most common AMR pathogens in India include Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa 3.
- The study also highlights the importance of understanding the burden of AMR and the leading pathogen-drug combinations contributing to it, in order to make informed and location-specific policy decisions 3.
Factors Contributing to AMR in India
- The factors contributing to AMR in India are complex and multifaceted, including the overuse and misuse of antibiotics, poor infection control practices, and lack of access to clean water and sanitation 2.
- The study also highlights the importance of addressing the social, economic, and cultural determinants of health in order to combat AMR 2.
- The use of antibiotics in agriculture and animal husbandry is also a significant contributor to AMR in India, with the country being one of the largest users of antibiotics in agriculture 4.
Impact of AMR on Healthcare Systems
- The impact of AMR on healthcare systems in India is significant, with resistant infections leading to increased morbidity, mortality, and healthcare costs 5.
- The study highlights the need for effective stewardship programs to promote the rational use of antibiotics and reduce the spread of resistant infections 5.
- The development of new antibiotics and alternative therapies is also critical in combating AMR, with the study highlighting the need for increased investment in research and development 4.