Kids up to 4 are main victims of antibiotics over-prescription

636 per 1,000 patients in this age group given these drugs, which are routinely ordered even for ailments not requiring them

Of every five patients reporting common ailments, at least two patients end up being prescribed powerful antibiotics. Approximately, 51.9 crore antibiotic prescriptions were dispensed in the private sector, translating to up to 412 prescriptions for every thousand patients, reveals a study, Outpatient antibiotic prescription rate and pattern in the private sector in India: Evidence from medical audit data.

What is worrisome is that most of these antibiotics were given to children in the age group of 0 to 4. The average prescription rate was 636 per thousand patients in this age group.

According to the study, most of the prescriptions were for acute upper respiratory infections (20.4 per cent), unspecified acute lower respiratory infection (12.8 per cent), disorders of urinary system (6 per cent), cough (4.7 per cent) and acute nasopharyngitis or viral sore throat (4.6 per cent).

“Although clinical guidelines on judicious antibiotic-use explicitly mentions that antibiotics should not be prescribed for common cold, non-specific upper respiratory tract infection, acute cough illness, and acute bronchitis, literature from India indicates high rate of antibiotic prescriptions for respiratory infections in primary care,” notes co-author Habib Hasan Farooqi of the Indian Institute of Public Health, Gurugram.

Commonly prescribed

. The authors argue that acute upper respiratory infections, cough, acute nasopharyngitis and acute pharyngitis are viral in origin and self-limiting. “Hence, in the light of evidence-based medicine and standard treatment guidelines, it may be argued that a significant proportion of these antibiotic prescriptions might be inappropriate. Previous research on prescription practices also highlighted the problem of inappropriate use of broad-spectrum antibiotics in India.” the study says

The paper states that prescriptions with cephalosporins and quinolones at 38.2 per cent and 16.3 per cent, respectively, in India were significantly higher than in the US (14 per cent and 12.7 per cent), and Greece (32.9 per cent and 0.5 per cent). “Up to 10 crore, or one-fifth, of antibiotic prescriptions were dispensed just for upper respiratory infections, which rarely require an antibiotic therapy,” the paper says.

The study argues that in India, not only is the prescription rate higher, but the choice of antibiotics for the treatment of uncomplicated respiratory infections too, was inappropriate. It notes that limited access to medicines in the public sector also results in over-the-counter purchase of antibiotics, which is a key cause of inappropriate use.