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Cited by 96Antibiotic Use and ResistanceAntibiotic Resistance in BacteriaPharmaceutical and Antibiotic Environmental Impacts

Community level antibiotic utilization in India and its comparison vis-à-vis European countries: evidence from pharmaceutical sales data

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Farooqui, Habib Hasan, Selvaraj, Sakthivel, Mehta, Aashna, Heymann, David L.·2018·PLoS ONE
DOI 10.1371/journal.pone.0204805PMC PMC6192587
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Abstract

India was the largest consumer of antibiotics in 2010 in the world. Evidence suggests that countries with high per-capita antibiotic consumption have higher rates of antibiotic resistance. To control antibiotic resistance, not only reduction in antibiotic consumption is required, socio-economic factors like access to clean water and sanitation, regulation of private healthcare sector and better governance are equally important. The key objective of this research was to investigate the five year trends in consumption of major antibiotic classes in India and compare them with European Surveillance of Antimicrobial Consumption Network (ESAC-Net) countries. We used Intercontinental Marketing Statistics (IMS) Health (now IQVIA) medicine sales audit data of antibiotic sales in the retail private sector (excluding the hospitals sector) in India. We then standardized dosage trends and assigned defined daily dose (DDD) to all formulations based on the ATC/DDD index. We expressed our data in standardized matrices of DDD per 1000 inhabitants' per day (DID) to compare antibiotic use in India with ESAC-Net countries. The antibiotic use was plotted and reported by year and antibiotic class. Our main findings are-per capita antibiotic consumption in the retail sector in India has increased from 13.1 DID in 2008 to 16.0 DID in 2012-an increase of ~22%; use of newer class of antibiotics like carbapenems (J01DH), lincosamides (J01FF), glycopeptides (J01XA), 3rd generation cephalosporins (J01DD) and penicillin's with beta-lactamase inhibitors has risen; and antibiotic consumption rates in India are still low as compared to ESAC-Net countries (16.0 DID vs. 21.54 DID). To conclude our study has provided the first reliable estimates of antibiotic use in the retail sector in India vis-à-vis ESAC-Net countries. In addition, our study could provide a reference point to measure the impact of interventions directed towards reducing antibiotic use.

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  • Studies from India indicate that the use of newer classes of antibiotics is disproportionately high.

    “Studies from India, including analysis of antibiotics sales data, indicate that the use of newer classes of antibiotics is disproportionately high.2,5”

    From Consumption of systemic antibiotics in India in 2019 (2022) · cites this paper as [5]

    The Results and discussion report increased use of newer antibiotic classes in Indian retail sales data and say that, in the private sector, newer antibiotics were used more often than older ones. They do not establish that use of newer classes is disproportionately high across India generally; the paper's sales analysis excludes hospitals. (LLM, conf=0.82)

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  1. [38]Will achieve full immunization coverage for all children by 2020 through a Catch-Up campaign [Internet]. New Delhi: Press Information Bureau 2014 [cited 3/9/2016]. Available from: http://pib.nic.in/newsite/PrintRelease.aspx?relid=114103

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Authors
Farooqui, H. H., Selvaraj, S., Mehta, A., & Heymann, D. L.
Affiliations
  • Public Health Foundation of India (IN)
  • London School of Hygiene & Tropical Medicine (GB)
Corresponding author
  • Farooqui, Habib Hasan
  • Selvaraj, Sakthivel
  • Mehta, Aashna
  • Heymann, David L.
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2018-10-17
Volume
13
Issue
10
Pages
e0204805
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0204805
PMC
PMC6192587
OpenAlex
W2896222045
Cited by
96
References
31
Citations by year
2026: 7 · 2025: 9 · 2024: 13 · 2023: 16 · 2022: 13 · 2021: 20 · 2020: 14 · 2019: 4
FWCI
5.84
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Wellcome Trust (084754/Z/08/A)
Topics
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
Keywords
antibiotic use, community antibiotic use, defined daily doses, antibiotic resistance, carbapenems, lincosamides, glycopeptides, third-generation cephalosporins, beta-lactamase inhibitors, India, Europe, antimicrobial stewardship
MeSH terms
Anti-Bacterial Agents, Commerce, Drug Industry, Drug Utilization, Europe, Humans, Pharmacies, Private Sector, Drug Resistance, Bacterial, Drug Dosage Calculations

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