Lok Sabha Question No. 2575 (UNSTARRED), answered on 2017-03-17
Subject: Drug Resistance
Ministry: HEALTH AND FAMILY WELFARE
Asked by: DARSHANA VIKRAM JARDOSH

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH RESEARCH

LOK SABHA UNSTARRED QUESTION NO. 2575 TO BE ANSWERED ON 17 TH MARCH, 2017

## DRUG RESISTANCE

## 2575. SHRIMATI DARSHANA VIKRAM JARDOSH:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) the details of bacteria/viruses found in the country that have shown signs of drug re various studies carried out by ICMR or other agencies during the last three years along reasons therefor;
- (b) the action taken by the Government in consultation with the State Governments and entities to contain this rising trend;
- (c) whether the Government proposes to send advisory to MCI, IMA, State Governments to cu the tendency of adv ising unnecessary strong antibiotics to patients thereby making them dr resistant; and
- (d) if so, the details thereof and if not, the reasons therefor?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE ( SMT. ANUPRIYA PATEL )

- (a) : Indian  Council  of  Medical  Research  (ICMR)  in  2013,  set  up  an  Anti - Microbial Resistance (AMR) surveillance network which is currently networking the tertiary care hos in the country.

Data obtained from across the country shows that, more than 70% Enterobacteriaceae resistant to 3rd -generation cephalosporins. Among the Enterobacteriaceae species, Klebsiella a Escherichia coli have been found to be resistant to 3rd -generation cephal osporins (80%). A bulk of  hospital - acquired  infections  is  caused  by  Acinetobacter  baumannii  and  Pseudomonas aeruginosa  showing  50%  resistance  to  carbapenems.  Salmonella  Typhi  multidrug  resistan (MDR)  to  ampicillin,  chloramphenicol  and  trimethoprim -sulf amethoxazole  is  showing  a downward  trend  and  resistance  to  fluoroquinolones  is  increasing. The  list  of  the  pathogens covered under ICMR network covers 90% of the World Health Organisation (WHO) priority

Contd…..

pathogens. The aims of establis hing this network are (i) To collect nationally representative d on  drug  resistance  and  monitor  trends  across  the  country,  (ii)  To  generate  eviden mechanisms of resistance in different pathogenic groups, (iii) To guide antimicrobial pol both treatment and prophylaxis; and (iv) To direct hospital infection control efforts tha prevention of the spread of resistant organisms.

(b) : As informed by Central Drugs Standard Control Organisation (CDSCO), in order to hav focused regulat ion on manufacture and sale of antibiotics and habit forming drugs, the Drug Cosmetics Rule, 1945 were amended vide Gazette Notification No GSR 588 (E) dated 30 - 082013 w.e.f. 01.03.2014 incorporating a new Schedule H1 containing 46 drugs which include 24 IIIrd & IVth generation antibiotics, 11 Anti TB drugs and 11 habit forming drugs.

The drugs falling under Schedule H1 are required to be sold  in the country unde following conditions:

(1) To  be  labelled  with  the  symbol  Rx  which  shall  be  in  red and  conspicuously displayed on the left top corner of the label.  It shall also be labelled with the words in a box with a red border:

'Schedule H1 Drug - Warning:

-It is dangerous to take this preparation except in accordance with the medical advi ce.

-Not to be sold by retail without the prescription of a Registered Medical Practitioner'.

(2) The supply of a drug specified in Schedule H1 shall be recorded in a sepa register at the time of the supply giving the name and address of the prescriber , the nam  of the  patient,  the  name  of  the  drug  and  the  quantity  supplied  and  such  records  sh maintained for three years and be open for inspection.

(c)& (d) : Ministry of Health and Family Welfare (MoHFW) has identified National Center for Dise ase Control, New Delhi (NCDC) as a nodal agency for managing the burden of AMR in the country. NCDC developed and published National Policy for Containment of AMR in 2011. With  the  aim  to  establish  a  national  laboratory  based  surveillance  system  by  stren gthening laboratories for AMR, to generate quality data on AMR for pathogens of public health rele and  to  generate  awareness  about  rational  use  of  antibiotics  in  the  community  and  heal providers and to strengthen infection control guidelines an d practices.

…………….