On the occasion of the World Antibiotic Awareness Week, ReAct Asia-Pacific organized a half-day workshop on antimicrobial resistance for media personnel in Trivandrum, Kerala, the southern-most province of India. Over two dozen media personnel took part in the workshop that dealt with various aspects of antimicrobial resistance, including the need for an ecological approach to find sustainable and long-lasting solutions.
Dr Sujith Chandy, Head, ReAct Asia Pacific pointed to the trend within the pharmaceutical industry of focusing on drugs for chronic diseases such as diabetes and hypertension, while minimizing research and development on medicines for infectious diseases. He said:
“The loss of effectiveness of existing antibiotics is particularly worrying as there are no new antibiotics in the pipeline.”
Dr Chandy said in the absence of new drugs the medical fraternity was turning to old drugs like Colistin to overcome antimicrobial resistance, which were still effective but also more toxic to patients. Even the effectiveness of Colistin was under threat as it was used widely in food-animal production and instances of resistance to this last-resort drug were being reported in different parts of the world.
Media’s role important – quality reporting needed
Satya Sivaraman, Communications Coordinator, ReAct Asia Pacific said that the media had a crucial role in demystifying medical concepts and helping the public understand issues related to antimicrobial resistance. He said:
“There were studies which showed that a lot of antibiotic consumption, particularly in pediatrics, was driven by anxiety of patients, who then put pressure on doctors to prescribe these drugs. Fear of bacteria was irrational and a better understanding of the role these microorganisms play in the sustenance of life and living processes all around us.”
Dr Philip Mathew, Consultant, ReAct Asia Pacific presented ReAct’s work both in India and around the globe to the media personnel. He said:
“The media has an important role in communicating the threat of antimicrobial resistance and measures to tackle it to a wide range of audiences. Good quality reportage, based on an accurate understanding of antimicrobial resistance, could help change both state policy and awareness levels of the general public.”
Material on antimicrobial use in food-animal production
Two ReAct Asia Pacific communication products, a resource book on problems due to and alternatives to use of antibiotics in food-animal production and the ‘No Antibiotics in Our Food!’ poster game, based on the popular slides and ladders game format, were distributed to the workshop participants.
Material to download
Long-term interaction with media after workshop
ReAct Asia Pacific plans to follow up with the media personnel who attended the workshop and engage in a long-term interaction to ensure regular and accurate coverage of antimicrobial resistance related issues. Kerala, which has the best healthcare indicators in India, is also the first Indian state to work on a sub-national plan to tackle antimicrobial resistance, details of which are expected to announced in the near future.
High rate of antibiotic prescriptions in India
Several studies in India have shown a high rate of antibiotic prescription by physicians. For example, one study  found that 69.4% of patients surveyed, who had symptoms of viral aetiology were prescribed antibiotics whereas going by the overall data on burden of communicable disease in India only 10-15% of infections have bacterial etiology and therefore truly need antibiotics. This according to the study points to a significant overuse of antibiotics.
Yet another study of patients visiting community healthcare facilities found that among 52,788 patients, 40.9% were prescribed or dispensed antibiotics. There were significant differences among facilities types and areas. Fluoroquinolones and penicillins were widely used, co-trimoxazole more in rural hospitals and cephalosporins in urban private hospitals. 41.1% of antibiotics were for respiratory infections.
In response to this high rate of antibiotic prescription, in 2016 the Indian Ministry of Health launched it’s ‘Medicines with the Red Line’ public awareness campaign that highlights the importance of taking antibiotics only when prescribed by a doctor. Other key messages include: learning how to identify prescription drugs; curb self-medication; and become more aware of the dangers of misusing antibiotics.
Antibiotics are already included in a special list of restricted drugs by law but there have been difficulties in implementation of the policy and monitoring of sales.
 S KI, Chandy SJ, Jeyaseelan L, Kumar R, Suresh S. Antimicrobial prescription patterns for common acute infections in some rural and urban health facilities of India. Indian J Medical Research August 2008;128 (2): 165-71.
 Chandy SJ, Thomas K, Mathai E, Antonisamy B, Holloway KA, Stalsby Lundborg C. Patterns of antibiotic use in the community and challenges of antibiotic surveillance in a lower-middle-income country setting: a repeated cross-sectional study in Vellore, south India. J Antimicrob Chemother. 2013 Jan;68(1):229-36.