A study has highlighted the excessive use of antibiotics like azithromycin by Indians during and before COVID-19 pandemic. The research, published in Lancet Regional Health-Southeast Asia, said that most of these drugs were not approved by the central drug regulator and called for "significant policy and regulatory reform". The research was published in the reputed journal on September 1. It said that the study is important because inappropriate use of antibiotics is a significant driver of antibiotic resistance in India.
The study also said that an overlap in regulatory powers between national and state-level agencies complicate antibiotics availability, sales, and consumption in the country.
"Although the per-capita private-sector consumption rate of antibiotics in India is relatively low compared to many countries, India consumes a large volume of broad-spectrum antibiotics that should ideally be used sparingly," the study said.
The study also acknowledged the contribution made by Aashna Mehta, from New Delhi-based Public Health Foundation of India.
The researchers said they analysed data from PharmaTrac, a private-sector drug sales dataset gathered from a panel of 9,000 that are representative of sales figures across India. The metric used defined daily dose (DDD) to calculate the per capita private-sector consumption of antibiotics.
The findings showed that total DDDs consumed in 2019 was 5,071 million, translating to 10.4 DDD per 1,000 population per day. "Twelve antibiotic molecules constituted 75% of the total consumption. Azithromycin was the most consumed antibiotic molecule (640 million DDDs, 12.6%), followed by cefixime (516 million, 10.2%). Azithromycin 500mg tablet was the most consumed formulation (384 million DDDs, 7.6%), followed by cefixime 200 mg tablet (331 million DDDs, 6.5%)," the researchers said in the study.
"Formulations listed in the NLEM (national list of essential medicines) contributed 49.0% (2486 million DDDs); FDCs contributed 34.0% (1722 million), and unapproved formulations contributed 47.1% (2408 million DDDs)," they added.
It also said that there were 1,098 unique formulations and 10,100 unique products (brands) of antibiotics in India.