‘Azithromycin most misused drug in India’

KOCHI: Indians took an excessive amount of antibiotics like azithromycin during and before the Covid-19 pandemic although many of these drugs weren’t cleared by the central drug regulator, according to a study published in Lancet Regional Health-Southeast Asia. The researchers investigated antibiotic sales in private hospitals in India in 2019 (pre-Covid times) and found that most of them wer e used inappropriately.

The findings assume importance considering the growing threat of antibioticresistance in India. “India consumes a large volume of broad-spectrum antibiotics, including azithromycin that should ideally be used sparingly. Broad-spectrum drugs are meant to be used when we have confirmedmultiple bacterial infections, or we have strong suspicion, especially in certai n patients, who are at high risk,” said Dr Muhammed Shaffi, lead a uthor of the study. “Using them for even trivial upper respiratory tract infections,which are mostly viral infections, is a threat to preserving the potential of available antibiotics,” he said. The study was conducted along with a researcher from the Public Health Foundation of India, New Delhi.

Centrally unapproved formulations accounted for 44% of the total defined daily dose. “As many as 1,098 unique formulations and 10,100 unique products (brands) of antibiotics are sold in India. Out of them, only 46% of brands (19% of formulations) belonged to the Central Drugs Standard Control Organisation(CDSCO) under the directorate general of health services, ministry of health and family welfare,” said Shaffi. He said companies obtain marketing licences from states without the central regulator’s approval. “The overlap in regulatory powers between national and state-le vel agencies complicates antibiotics availability, sales, and consumption in the country. ”

However, the study has its limitations. “It looks at only one aspect of antibiotic misuse. There are antibiotic residues found in the environment, water sources, milk, fish, meat, and other food items, including in drugs and we are working on measures to minimise the risk of antibiotic resistance,” said Dr Arvind R, head of department of infectious diseases at Thiruvananthapuram medical college.