India is the largest consumer of antibiotics globally

India has emerged as the world's largest consumer of antibiotics followed by China and the US, according to a new study which quantifies the growing alarm surrounding antibiotic-resistance.

Global use of antibiotics is surging, according to Princeton University researchers who have conducted a broad assessment of antibiotic consumption around the world.

The study, "Global Trends in Antibiotic Consumption, 2000-2010," found that worldwide antibiotic use has risen a staggering 36 per cent over those 10 years, with five countries - Brazil, Russia, India, China and South Africa (BRICS) - responsible for more than three-quarters of that surge. 

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Among the 16 groups of antibiotics studied, cephalosporins, broad-spectrum penicillins and fluoroquinolones accounted for more than half of that increase, with consumption rising 55 per cent from 2000 to 2010.

The study quantifies the growing alarm surrounding antibiotic-resistant pathogens, and a loss of efficacy among antibiotics used to combat the most common illnesses.

The report also highlights an increasing resistance to carbapenems and polymixins, two classes of drugs long considered "last resort" antibiotics for illnesses without any other known treatment.

Overall, the study reviewed patterns, seasonality and frequency of use of antibiotics in 71 countries.  

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The data underscore the welcome evidence that more global citizens are able to access and purchase antibiotics.

But that use is not being effectively monitored by health officials, from doctors to hospital workers to clinicians, noted the researchers. Consequently, antibiotic use is both rampant and less targeted.

That reality is driving antibiotic resistance at an unprecedented rate, researchers said.

"We have to remember that before we had antibiotics, it was pretty easy to die of a bacterial infection," said Ramanan Laxminarayan, a research scholar with the Princeton Environmental Institute.

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"And we're choosing to go back into a world where you won't necessarily get better from a bacterial infection.

It's not happening at a mass scale, but we're starting to see the beginning of when the antibiotics are not working as well," Laxminarayan said.

The study found that India was the single-largest consumer of antibiotics in the world in 2010, followed by China and the US.
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The study also found that antibiotic consumption has flattened in the US, compared with the five BRICS countries.

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But US citizens per capita still account for far more antibiotic consumption than any other population, with a rate of more than twice that of India.

The study noted that antibiotic use tended to peak at different times of the year, corresponding in almost every case with the onset of the flu season.

The finding was published in the journal The Lancet Infectious Diseases.

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