New Delhi: Over 50 percent of antibiotics prescribed in India are those with a potential to cause high antimicrobial resistance, according to a government report based on India’s first large-scale multi-centric study on the use of the medicines. The report calls this a “concerning trend”.

The First Multicentric Point Prevalence Survey of Antibiotic Use at 20 NAC-NET Sites India 2021-22 was conducted by the National Centre for Disease Control (NCDC) under the Union health ministry.

The report was released Tuesday.

The National Antimicrobial Consumption Network (NAC-NET) consists of 35 tertiary-care institutes across India, and has been monitoring antibiotic consumption at these facilities for the past five years.

According to the report, the survey findings indicate a “remarkably high prevalence” of antibiotic usage (71.9 percent), with 4.6 percent of the patients getting four or more antibiotics.

Out of the 20 sites where the assessment was carried out, four had more than 95 percent prevalence of antibiotic use, the report says, before offering a breakdown of the types prescribed (‘watch’ or ‘access’).

According to the AWaRe classification of antibiotics developed by the World Health Organization (WHO) in 2017, ‘watch’ antibiotics generally have a higher potential for antimicrobial resistance, and are more commonly used in sicker patients in medical facilities.

These medicines, according to the world health body, should be prescribed carefully to avoid misuse.

Access antibiotics are those with a narrow spectrum of activity, generally with fewer side-effects, and a lower potential for antimicrobial resistance and lower cost.

These are recommended for the empiric treatment of most common infections.

The classification also includes a third group — ‘reserve’ antibiotics — that are last-resort medicines and should only be used to treat severe infections caused by multidrug-resistant pathogens.

The government survey found that, at 57 percent, ‘watch’ group antibiotics were on average prescribed more frequently at the 20 sites, than those under ‘access’ (38 percent). The trend was the other way round at two sites.

In 2019, the WHO included antimicrobial resistance as one of the top 10 threats to public health.

The report says that the discovery of antibiotics has been a groundbreaking advancement that revolutionised the approach to infectious diseases, but these “once-miraculous drugs” have become less effective due to various factors.

“One of these factors is the indiscriminate, excessive, and inappropriate use of antibiotics,” it says.