Washington D.C.: Antibiotic resistance is a problem worldwide, but is particularly worrying in India, where hospital standards are inconsistent and antibiotics are readily available over the counter at pharmacies. Now, a recent study suggests a range of interventions that could help.


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A mix of poor public health systems, high rates of infectious disease, inexpensive antibiotics and rising incomes are coming together to increase prevalence of resistant pathogens and is increasing the burden of untreatable neonatal sepsis and health-care-associated infections.


However, a few urgent priorities for immediate implementation could make a difference, according to Ramanan Laxminarayan from the Center for Disease Dynamics, Economics & Policy, Washington DC, United States and Ranjit Roy Chaudhury, from Apollo Hospitals Educational and Research Foundation, New Delhi, India.


The authors noted that over-the-counter access to antibiotics is a problem, but regulations to restrict access have to be balanced against the need to maintain access for the significant proportion of the population that lacks access to doctors. Indeed, lack of access to effective and affordable antibiotics still kills more children in India than does drug resistance


The authors argue that better regulation in India to curb overuse of antibiotics being sold over the counter and as growth promoters for livestock, alongside efforts to promote behaviour change and improve India's health system could help to curb rising antibiotic resistance.


The study appears in PLOS Medicine.