The developing world, particularly India and South Africa, could be responsible for growing antibiotic resistance, thanks to galloping rates of antibiotic usage. A study by the Washington, DC-based Center for Disease Dynamics, Economics and Policy maps antibiotic resistance for 12 types of bacteria in 39 countries and trends in antibiotic use in 69 countries over the past 10 years. As per the study, global antibiotic usage grew by 30% between 2000 and 2010, driven by increased consumption in developing nations, where these drugs are widely available over the counter. The authors of the study explain that the poor sanitation conditions in these countries have fostered antibiotic reliance. The study pointed to livestock as another area of antibiotic overuse, with the problem being quite acute in China—in 2010 alone, 15,000 tonnes of antibiotics were put to such use and this consumption is set to double by 2030. The overuse of antibiotics, coupled with the fact that discovery of new antibiotics has slowed considerably, has meant that resistance is on the rise—in India, for instance, the number of carbapenem-resistant Klebsiella pneumoniae infections rose from 29% of all K. pneumoniae infections in 2008 to 57% in 2010.
Developed nations, in comparison, have done better and have started to institute measures to regulate antibiotic use. In the UK, less than 10% of K. pneumoniae infections have been found to be carbapenem resistant while the number of methicillin-resistant Staphylococcus aureus (MRSA) infections has fallen sharply over the past eight years. Responding to the challenge of increasing resistance in countries like India must begin with addressing sanitation needs, while drug disbursal also would need more rigorous checks. But as long as globally uniform regulation of antibiotic use is not in place, the spread of resistance would remain a threat.