DBT Wellcome Trust Fellow, DBT-National Centre for Cell Science, Pune-411021, India.
J Epidemiol Glob Health. 2021 Dec;11(4):444-452. doi: 10.1007/s44197-021-00008-2. Epub 2021 Sep 28.
Antimicrobial resistance (AMR) is a global public health concern because of its fast spread. India, one of the world's top consumer of antibiotics and second most populated country has its unique constraints of social, cultural and economic strata. The continual self-medication, use of antibiotics for the growth promotion in animals, and accumulation of residual antibiotics in the environment challenge the implementation of AMR containment policy. Hence, the present review attempts to delineate the influence of antibiotics abuse on the human, animal and environmental health under the realm of one health. It was based on the literature search using public databases to highlight the rapid surge in the burden of AMR in India affecting various sectors and/or ecosystems in India. It was found that the irrational and overuse of antibiotics in different sectors have led to the emergence of extended antimicrobial resistance wherein the environment acts as a reservoir of antibiotic resistance genes (ARGs); completing the cycle of contamination and recontamination. There are efforts by government policy makers to reduce the burden of AMR in the country to reduce the health risks, through the One Health approach. Parallel efforts in educating healthcare professionals, strict legislation for pharmacies and pharmaceutical companies should be prioritize. At the same time surveillance of newly emerged AMR pathogens, prioritising research focusing on AMR, and awareness camps or programs among the local population is critical while addressing the consequences of spared of AMR in India.
抗微生物药物耐药性(AMR)因其快速传播而成为全球公共卫生关注的问题。印度是世界上抗生素消费最多的国家之一,也是人口第二多的国家,它有着独特的社会、文化和经济阶层的限制。持续的自我用药、在动物中使用抗生素促进生长以及环境中残留抗生素的积累,都对 AMR 遏制政策的实施构成了挑战。因此,本综述试图在一个健康的框架内阐述抗生素滥用对人类、动物和环境健康的影响。它是基于使用公共数据库进行文献检索的结果,强调了印度 AMR 负担的快速增加,影响了印度的各个部门和/或生态系统。研究发现,不同部门对抗生素的不合理和过度使用导致了扩展的抗微生物耐药性的出现,其中环境充当了抗生素耐药基因(ARGs)的储存库;完成了污染和再污染的循环。政府政策制定者正在通过一个健康的方法来努力减轻该国的 AMR 负担,以降低健康风险。同时,应优先重视教育医疗保健专业人员、对药店和制药公司实行严格的立法。在解决印度 AMR 幸免的后果时,同时还应监测新出现的 AMR 病原体,优先研究 AMR 问题,并在当地居民中开展宣传活动或计划。