Lax antibiotic controls raise killer disease fears

AFP/New DelhiA pharmacist swiftly pulls white boxes of powerful antibiotics from neatly stacked shelves behind him, and hands them over the counter without asking for a doctor’s prescription.Faronem and Linospan, drugs used to fight acute bacterial infections such as severe pneumonia and bronchitis, are supposed to be remedies of last resort.Their sale is illegal without a prescription under a law introduced last year.But a reporter easily bought them this week for about Rs700 from a busy pharmacy in an upmarket New Delhi suburb.Doctors and other health experts say such easy access to antibiotics in India, home to 1.2bn people, is stoking bacterial resistance to drugs, a global problem that could see long-treatable diseases become killers once again.“Growing resistance to antibiotics is a terror for the health of our people,” the country’s chief drugs regulator G N Singh said.“Misuse, overuse should not happen, else there will come a time when the simplest illnesses will be hard to cure,” said Singh, the drugs controller general of India. But he was “not surprised” the drugs were easy to obtain, saying cracking down on chemists and over-prescribing doctors and educating patients about the dangers of overusing them was an uphill battle.A study published this month by Princeton University said India and other major developing countries were largely to blame for overuse of antibiotics.India’s $12.4bn pharmaceutical industry manufactures almost a third of the world’s antibiotics.The country’s growing middle class is increasingly popping antibiotics as a quick-fix rather than allowing their immune systems to fight common illnesses. Doctors also wrongly prescribe antibiotics for viral infections against which they are wholly ineffective, said Sudeep Khanna, a Delhi-based gastroenterologist. “There is often a lot of pressure from the patients because they want immediate relief and even doctors tend to over-treat in hopes that the patient will recover quickly,” Khanna said.The study called “Global Trends in Antibiotic Consumption 2000-2010” found antibiotic use worldwide had risen 36% in that time period.India emerged as the world’s largest consumer, with the country’s use of antibiotics growing 62% over a decade, from 8bn units in 2001 to 12.9bn units in 2010.Experts say overuse is giving rise to dangerous drug-resistant superbugs - with huge consequences for India, home to millions of poor and already sick people. India’s inadequate sanitation increases the chances of infections from drug-resistant bacteria.“Given our high background rates of infections, antibiotic resistance has potentially more serious consequences for us than for countries that may have better sanitation and infection control,” author Ramanan Laxminarayan said.Superbug NDM-1 (New Delhi metallo-beta-lactamase 1) created global panic when it was found in the capital in 2010 and showed resistance even to carbapenems, a group of antibiotics often reserved as a last line of defence.For India, such superbugs also risk damaging its $1.2bn medical tourism industry, in which swanky new hospitals offer everything from facelifts to fertility treatment at a fraction of the price of Western countries.