For antibiotics, the right dose is restraint, Pg12

Key Highlights:

• A global study published in The Lancet Public Health revealed India's over-reliance on "watch" antibiotics and underuse of "access" antibiotics.
• The World Health Organisation (WHO) classifies antibiotics into "access," "watch," and "reserve" categories based on their resistance potential.
• India's actual antibiotic use stands at 18.3 Defined Daily Doses (DDD) per 1,000 people per day, exceeding the optimal range of 9.9 to 14.7 DDD.
• "Watch" antibiotics are used at 9.3 DDD against a recommended 6 DDD, while "access" antibiotics are at 4.5 DDD, falling short of needs.
• The National Action Plan on Antimicrobial Resistance 2.0 (2025-2029) aims to curb inappropriate antibiotic usage across human healthcare, animal husbandry, and agriculture.

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Detailed Insights:

• The preference for broad-spectrum "watch" drugs is driven by patient demand for quick recovery and doctors operating in overstretched healthcare systems.
• Unnecessary use of stronger antibiotics accelerates Antimicrobial Resistance (AMR), making future infections harder and more expensive to treat.
• The underuse of "reserve" antibiotics for genuinely resistant cases indicates systemic failures in ensuring the right medicine reaches the right patient.
• Factors contributing to India's rising AMR burden include fragmented healthcare delivery, poor diagnostic access, and liberal antibiotic use in livestock and agriculture.
• The National Action Plan on Antimicrobial Resistance 2.0 (2025-2029), launched on November 18, 2025, is a five-year roadmap to combat AMR through a One Health approach.
• The plan emphasizes antimicrobial stewardship and calls for stricter compliance across the pharmaceutical supply chain to curb indiscriminate over-the-counter sales and irrational fixed-dose combinations.

Key Concepts Involved:

• Antimicrobial Resistance (AMR): When microorganisms evolve to withstand drugs designed to kill them, making infections difficult or impossible to treat.
• Antimicrobial Stewardship: Coordinated efforts to promote the optimal use of antimicrobial agents to preserve their effectiveness and reduce resistance.
• Defined Daily Doses (DDD): A statistical measure representing the assumed average maintenance dose per day for a drug used for its main indication in adults.
• WHO AWaRe classification: A framework categorizing antibiotics into Access (first-line), Watch (broader-spectrum, reserved for specific situations), and Reserve (last-line for highly resistant infections) groups.