title: Rationalizing antibiotic use to limit antibiotic resistance in India.
abstract: Antibiotic resistance, a global concern, is particularly pressing in developing nations, including India, where the burden of infectious disease is high and healthcare spending is low. The Global Antibiotic Resistance Partnership (GARP) was established to develop actionable policy recommendations specifically relevant to low- and middle-income countries where suboptimal access to antibiotics - not a major concern in high-income countries - is possibly as severe a problem as is the spread of resistant organisms. This report summarizes the situation as it is known regarding antibiotic use and growing resistance in India and recommends short and long term actions. Recommendations aim at (i) reducing the need for antibiotics; (ii) lowering resistance-enhancing drug pressure through improved antibiotic targeting, and (iii) eliminating antibiotic use for growth promotion in agriculture. The highest priority needs to be given to (i) national surveillance of antibiotic resistance and antibiotic use - better information to underpin decisions on standard treatment guidelines, education and other actions, as well as to monitor changes over time; (ii) increasing the use of diagnostic tests, which necessitates behavioural changes and improvements in microbiology laboratory capacity; (iii) setting up and/or strengthening infection control committees in hospitals; and (iv) restricting the use of antibiotics for non-therapeutic uses in agriculture. These interventions should help to reduce the spread of antibiotic resistance, improve public health directly, benefit the populace and reduce pressure on the healthcare system. Finally, increasing the types and coverage of childhood vaccines offered by the government would reduce the disease burden enormously and spare antibiotics.
authors: National Institute of Immunology, New Delhi, India.
authors: Nirmal K
authors: NK
authors: Ganguly
authors: N K
authors: NK
authors: Arora
authors: Sujith J
authors: SJ
authors: Chandy
authors: Mohamed Nadeem
authors: MN
authors: Fairoze
authors: J P S
authors: JP
authors: Gill
authors: Usha
authors: U
authors: Gupta
authors: Shah
authors: S
authors: Hossain
authors: Sadhna
authors: S
authors: Joglekar
authors: P C
authors: PC
authors: Joshi
authors: Manish
authors: M
authors: Kakkar
authors: Anita
authors: A
authors: Kotwani
authors: Ashok
authors: A
authors: Rattan
authors: H
authors: H
authors: Sudarshan
authors: Kurien
authors: K
authors: Thomas
authors: Chand
authors: C
authors: Wattal
authors: Alice
authors: A
authors: Easton
authors: Ramanan
authors: R
authors: Laxminarayan
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000382:microbiology; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data* / Q000639:trends*; D006291:Health Policy / Q000331:legislation & jurisprudence*; D007194:India; D011640:Public Policy
chemical_list: D000900:Anti-Bacterial Agents