About 57,000 newborn babies in India die annually due to drug-resistant sepsis, according to a study which found that the increased use of over-the-counter antibiotics without prescriptions is leading to the spread of superbug infections worldwide.
The study highlights the need for better enforcement of laws in the global fight against superbugs.
The study, published in The Journal of Infection, showed that antibiotics the most frequently prescribed medicine worldwide.
Antibiotic resistance is a major global health threat which accounts for more than two million infections and 23,000 deaths annually in the US, researchers found.
Between 2000 and 2010, consumption of antibiotics increased globally from 50 billion to 70 billion standard units. Majority of overall increase in consumption occurred in Brazil, Russia, India, China and South Africa, the study found.
"Reliable estimates of the burden of antibiotic-resistant infections in developing countries are lacking but it is believed to cause many more deaths in these countries," said Emmanuel Adewuyi, from Queensland University of Technology (QUT) in Australia.
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"In India, for example, about 57,000 neonatal sepsis deaths occurring annually are due to antibiotic-resistant infections," he added.
Global increase was driven in part by economic growth and access to antibiotics. Pooled proportion of non-prescription supply of antibiotics in community pharmacies was 62 per cent, researchers said.
South America has the highest incidence of non-prescription supply of antibiotics in community pharmacies.
"We searched global databases for studies published from 2000 to 2017 which reported on the frequency of non-prescription sale and supply of antibiotics in community pharmacies worldwide," said Adewuyi.
"Studies from 24 countries were analysed and to our alarm we discovered that antibiotics are frequently supplied without prescription in many countries," he said.
"This overuse of antibiotics could facilitate the development and spread of antibiotic resistance. Antibiotic resistance accounts for more than two million infections and 23,000 deaths annually in the US, and around 25,000 deaths in Europe each year," Adewuyi said.
Of the 24 countries included in the study, only Thailand did not classify antibiotics as prescription only, yet the supply of antibiotics with a prescription was commonplace in all.
"The majority of these antibiotics being supplied without prescription were for the treatment of disease conditions that were largely acute and self-limited, such as upper respiratory tract infections and gastroenteritis," Adewuyi said.
"Many were also broad-spectrum antibiotics like amoxicillin, azithromycin and others which increase the risk of the development of difficult-to-treat infections like the the deadly methicillin resistant Staphylococcus aureus," he said.
"Considering most countries have laws prohibiting over-the-counter sales of antibiotics, there is a need to ensure such laws are more strictly enforced where appropriate," he added.