In a recent survey detail released by the National Centre for Disease Control (NCDC), under the aegis of the Union Health Ministry, it was revealed that ceftriaxone is among the most prescribed antibiotics in hospitals across India. This drug also has a high potential to cause antimicrobial resistance.

The novel survey studied the pattern of antibiotic usage in 20 government hospitals across 15 states. It showed that 57 percent of antibiotics prescribed in hospitals had a high potential to cause antimicrobial resistance. The World Health Organization (WHO) has listed antimicrobial resistance as among the top ten threats to public health.

A senior NCDC official associated with the survey informed that the rationale behind taking up this survey was to understand the pattern of antibiotic usage in hospitals for patients so that appropriate measures could be taken to rationalize their usage.

Data released by market research firm IQVIA shows that Monocef, a popular brand for the drug ceftriaxone produced by Aristo Pharmaceuticals, Mumbai has been the top-selling drug in the past few months. This was followed by Augmentin, with active ingredients such as amoxicillin and clavulanic acid, manufactured by GlaxoSmithKline.

The survey conducted by the NCDC was the result of the First Multicentric Point Prevalence Survey of Antibiotic Use at the National Antimicrobial Consumption Network (NAC-NET), which has been monitoring the use of antibiotics at 35 tertiary facilities across India. The report sheds light on the fact that apart from ceftriaxone, the other top prescribed antibiotics include metronidazole, amikacin, piperacillin, and tazobactam. Ceftriaxone, piperacillin, and tazobactam are from the ‘watch group’ of antibiotics, which have a higher potential for antimicrobial resistance and are used in sicker patients in hospitals. WHO recommends that these drugs should be used with caution to avoid misuse.

Augmentin falls into the ‘access group’ of antibiotics, which have a narrow spectrum of activity, few side effects, and minimal potential for antimicrobial resistance. These are used for the empiric treatment of common infections. The third group is the 'reserve group’ of antibiotics, which should be used only in the treatment of severe infections due to multidrug-resistant pathogens.

Experts suggest that the outcome of the survey needs immediate attention from the authorities, and strict resistance prevention mechanisms should be enforced to contain this critical issue. The NCDC survey also highlights that antimicrobial resistance has emerged as a silent pandemic that threatens human and animal health and the environment. Thus, it is high time to take urgent measures against the misuse and overuse of antibiotics.

References:

1. https://theprint.in/health/ceftriaxone-among-indias-most-prescribed-antibiotics-increasingly-resistant-against-pathogens/1912291/

2. Taneja N, Sharma M. Antimicrobial resistance in the environment: The Indian scenario. The Indian journal of medical research. 2019 Feb;149(2):119.

3. Lee H, Jung D, Yeom JS, Son JS, Jung SI, Kim YS, Kim CK, Chang HH, Kim SW, Ki HK, Moon CS. Evaluation of ceftriaxone utilization at multicenter study. The Korean journal of internal medicine. 2009 Dec;24(4):374.

4. Tewabe A, Marew T, Birhanu G. The contribution of nano‐based strategies in overcoming ceftriaxone resistance: a literature review. Pharmacology Research & Perspectives. 2021 Aug;9(4):e00849.

(Inputs from various sources)

(Rehash/Dr. Sushmita Ganguli)