Abstract
A SYSTEMATIC REVIEW AND META-ANALYSIS OF ANTIBIOTIC RESISTANCE PATTERN IN INDIA - “ARE WE LOOSING THE BATTLE AGAINST THE BUG?”

Muthukumaran Thulasingam* and Sam Johnson Udaya Chander J.

ABSTRACT

More lives are being lost to even non-life threatening illnesses such as typhoid and common chest infections such as pneumonia as these are becoming harder to treat due to antibiotic resistance.[1] India has made a promising start by adopting the National Action Plan on AMR (2017-21) in April of 2017. The bottleneck is the available data in the AMR does not include daily defined doses of antibiotics and drug resistance index.[2] The objectives of this study are to conduct a systematic review and metanalysis of the consumption of selected antibiotics with respect to daily defined dose, resistance pattern of selected microorganisms, and the drug resistance index at country level during the last decade. Electronic search in PubMed/MEDLINE and Google Scholar was used to find published literatures using keywords antibiotic resistance, India and Human. Titles and abstracts were initially screened for eligibility.[3] The full texts of articles judged to be eligible were reviewed if they meet the inclusion criteria. The electronic searches identified 6749 articles of which 62 were found eligible. The resistance index in the year 2009 79% and in 2015 was 71%. A total 8 bacterial isolates were selected according to the list provided by WHO and the resistance pattern of all 8 isolates of bacteria were discouraging.[4] The change from being susceptible to being resistant is drastic in the last decade with 95% CI (16.6–41.7). Appropriate antibiotic use should be ensured by prohibiting over-the-counter sale of antibiotics and strengthening antimicrobial stewardship.[5] The urgency at the policy level needs to translate into action on the ground, which won’t happen until the healthcare, pharmaceutical and livestock sector is better regulated.[6]

Keywords: Antibiotic resistance, Resistance pattern, Resistance index, WHO, Antimicrobial stewardship.


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