India Losing Battle Against TB due to Overuse of Antibiotics

A Lancet study has indicated that India which as the world’s highest tuberculosis burden is also the world’s largest antibiotics consumer. The study was conducted to examine whether pharmacies have contributed to the usage of antibiotics inappropriately. Excess antibiotic usage causes antimicrobial resistance threatening the prevention and treatment of TB. The study showed that pharmacies frequently dispensed antibiotics to suspected TB patients, but none of these pharmacies dispensed first line anti-TB drugs without prescriptions. Antibiotics and steroids were readily dispensed by them, and Madhukar Pai, Canada Research Chair at McGill University said ‘our study clearly showed that not a single pharmacy gave away first line anti-TP drugs (isoniazid, rifampicin, ethambuton, pyrazinamide, and streptomycin) without prescription…however pharmacists have away other antibiotics and rarely referred patients with typical TB symptoms, and that means that they are contributing to delays in TB diagnosis.’ Two standardised patients one with 2-3 weeks of pulmonary TB symptoms and a second with microbiologically confirmed pulmonary TB were sent to 622 pharmacies in Delhi, Mumbai, and Patna, completing 1200 pharmacist interactions. Only 13% of simulated patients were correctly managed, versus 62% of patients with known TB. This study (published in the Lancet Infectious Diseases) showed the importance of engaging pharmacists for fighting tuberculosis and for curbing the misuse of antibiotics.