{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:39:14Z","timestamp":1791920354614,"version":"4.3.4"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Antimicrobial resistance (AMR) is one of the biggest threats to global public health. Selection of resistant bacteria is driven by inappropriate use of antibiotics, amongst other factors. COVID-19 may have exacerbated AMR due to unnecessary antibiotic prescribing. Country-level knowledge is needed to understand options for action.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To review the current situation with respect to AMR in India and initiatives addressing it. Identifying areas where more information is required will provide a call to action to minimize further rises in AMR and to improve patient outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>National AMR initiatives, antibiotic use and prescribing in India, and availability of susceptibility data, in particular for the key community-acquired respiratory tract infection (CA-RTI) pathogens (Streptococcus pneumoniae and Haemophilus influenzae) were identified. National and international antibiotic prescribing guidelines for specific CA-RTIs (community-acquired pneumonia, acute otitis media and acute bacterial rhinosinusitis) commonly used locally were also reviewed, plus local antibiotic availability. Insights from a local clinician and clinical microbiologist were sought to contextualize this information.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Many initiatives have been launched since AMR was recognized as a national priority and organizations such as the Indian Academy of Paediatrics and the Global Antibiotic Resistance Partnership have worked to build awareness. The Indian Ministry of Health and Family Welfare published a 5\u2005year national action plan on AMR. However, the burden of infectious disease and consumption of antibiotics in India is high. There have been national surveillance studies generating local data along with international studies such as Survey of Antibiotic Resistance (SOAR) and Antimicrobial Testing Leadership and Surveillance (ATLAS). For common RTIs, clinicians use a range of international and national guidelines. However, a more standardized inclusive approach to developing local guidelines, using up-to-date local surveillance data from community-acquired infections, could make guidelines more locally relevant. This would encourage more appropriate antibiotic prescribing and improve adherence. This would, in turn, potentially limit AMR development and improve patient outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkac212","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T15:37:57Z","timestamp":1661355477000},"page":"i10-i17","source":"Crossref","is-referenced-by-count":18,"title":["Country data on AMR in India in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicine and clinical outcome"],"prefix":"10.1093","volume":"77","author":[{"given":"Didem","family":"Torumkuney","sequence":"first","affiliation":[{"name":"GlaxoSmithKline , 980 Great West Road, Brentford, Middlesex TW8 9GS , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruna","family":"Poojary","sequence":"additional","affiliation":[{"name":"Department of Pathology and Microbiology, Breach Candy Hospital Trust , Mumbai, Maharashtra , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhaskar","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Manipal Hospitals , Bangalore, Karnataka , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puja","family":"Nijhara","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline , 252, Dr Annie Besant Road, Worli, 400030, Mumbai , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krunal","family":"Dalal","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline , 252, Dr Annie Besant Road, Worli, 400030, Mumbai , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rendani","family":"Manenzhe","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline , The Campus, Flushing Meadows, 57 Sloane Street, Bryanston, Gauteng, 2021 , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,6]]},"reference":[{"key":"2022090713490037400_dkac212-B1","article-title":"Antibiotic resistance \u2013 fact sheet","author":"WHO","year":"2020"},{"issue":"Suppl 1","key":"2022090713490037400_dkac212-B2","first-page":"dkac211","article-title":"Relevance of the Consensus Principles for Appropriate Antibiotic Prescribing in 2022","volume":"77","author":"Cant\u00f3n","year":"2022","journal-title":"J Antimicrobial Chemother"},{"key":"2022090713490037400_dkac212-B3","article-title":"Antimicrobial resistance \u2013 fact sheet","author":"WHO","year":"2021"},{"key":"2022090713490037400_dkac212-B4","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.4103\/jfmpc.jfmpc_275_19","article-title":"India's National Action Plan for antimicrobial resistance - an overview of the context, status and way ahead","volume":"8","author":"Ranjalkar","year":"2019","journal-title":"J Family Med Prim Care"},{"key":"2022090713490037400_dkac212-B5","article-title":"Global action plan on antimicrobial resistance","author":"WHO","year":"2015"},{"key":"2022090713490037400_dkac212-B6","doi-asserted-by":"crossref","first-page":"129","DOI":"10.3126\/ajms.v11i6.29427","article-title":"Tackling AMR crisis in India: changing paradigm","volume":"11","author":"Lahiry","year":"2020","journal-title":"Asian J Med Sci"},{"key":"2022090713490037400_dkac212-B7","article-title":"India Population","author":"Worldometer","year":"2022"},{"key":"2022090713490037400_dkac212-B8","article-title":"National Action Plan in antimicrobial resistance","author":"Ministry of Health and Family Welfare, Government of India","year":"2020"},{"key":"2022090713490037400_dkac212-B9","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/S1473-3099(13)70318-9","article-title":"Antibiotic resistance\u2014the need for global solutions","volume":"13","author":"Laxminarayan","year":"2013","journal-title":"Lancet Infect Dis"},{"issue":"Suppl 1","key":"2022090713490037400_dkac212-B10","doi-asserted-by":"crossref","first-page":"i3","DOI":"10.1093\/jac\/dkw073","article-title":"Results from the Survey of Antibiotic Resistance (SOAR) 2012\u201314 in Thailand, India, South Korea and Singapore","volume":"71","author":"Torumkuney","year":"2016","journal-title":"J Antimicrob Chemother"},{"key":"2022090713490037400_dkac212-B11","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1128\/CMR.00047-06","article-title":"Setting and revising antibacterial susceptibility breakpoints","volume":"20","author":"Turnidge","year":"2007","journal-title":"Clin Microbiol Rev"},{"key":"2022090713490037400_dkac212-B12","article-title":"Implementation of EUCAST breakpoints\/guidelines","author":"EUCAST","year":"2022"},{"key":"2022090713490037400_dkac212-B13","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/thx.2009.129502","article-title":"Clinical and economic burden of community-acquired pneumonia among adults in Europe","volume":"67","author":"Welte","year":"2010","journal-title":"Thorax"},{"key":"2022090713490037400_dkac212-B14","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1056\/NEJMoa1500245","article-title":"Community-acquired pneumonia requiring hospitalization among U. S. adults","volume":"373","author":"Jain","year":"2015","journal-title":"N Engl J Med"},{"issue":"Suppl 1","key":"2022090713490037400_dkac212-B15","doi-asserted-by":"crossref","first-page":"i85","DOI":"10.1093\/jac\/dkw067","article-title":"Results from the Survey of Antibiotic Resistance (SOAR) 2002\u201309 in Turkey","volume":"71","author":"Torumkuney","year":"2016","journal-title":"J Antimicrob Chemother"},{"issue":"Suppl 2","key":"2022090713490037400_dkac212-B16","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/j.1470-9465.2004.00862.x","article-title":"Building in efficacy: developing solutions to combat drug-resistant S. pneumoniae","volume":"10","author":"Jacobs","year":"2004","journal-title":"Clin Microbiol Infect"},{"key":"2022090713490037400_dkac212-B17","article-title":"Antimicrobial surveillance","author":"Pfizer"},{"key":"2022090713490037400_dkac212-B18","doi-asserted-by":"crossref","first-page":"61","DOI":"10.35772\/ghm.2019.01026","article-title":"Strategic approach for combating antimicrobial resistance (AMR)","volume":"1","author":"Inoue","year":"2019","journal-title":"Glob Health Med"},{"key":"2022090713490037400_dkac212-B19","article-title":"Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report. Early implementation","author":"WHO","year":"2020"},{"key":"2022090713490037400_dkac212-B20","article-title":"Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report: 2021","author":"WHO","year":"2021"},{"key":"2022090713490037400_dkac212-B21","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.4103\/0970-2113.99248","article-title":"Guidelines for diagnosis and management of community- and hospital-acquired pneumonia in adults: Joint ICS\/NCCP(I) recommendations","volume":"29","author":"Gupta","year":"2012","journal-title":"Lung India"},{"key":"2022090713490037400_dkac212-B22","article-title":"National Treatment Guidelines for Antimicrobial Use in Infectious Diseases","author":"National Centre for Disease Control","year":"2016"},{"key":"2022090713490037400_dkac212-B23","article-title":"Treatment Guidelines for antimicrobial use in common syndromes","author":"Indian Council of Medical Research","year":"2017"},{"key":"2022090713490037400_dkac212-B24","article-title":"Treatment Guidelines for antimicrobial use in common syndromes","author":"Indian Council of Medical Research","year":"2019"},{"key":"2022090713490037400_dkac212-B25","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1086\/511159","article-title":"Infectious Diseases Society of America\/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults","volume":"44","author":"Mandell","year":"2007","journal-title":"Clin Infect Dis"},{"issue":"Suppl 3","key":"2022090713490037400_dkac212-B26","doi-asserted-by":"crossref","first-page":"iii1","DOI":"10.1136\/thx.2009.121434","article-title":"BTS guidelines for the management of community acquired pneumonia in adults: update 2009","volume":"64","author":"Lim","year":"2009","journal-title":"Thorax"},{"issue":"Suppl 2","key":"2022090713490037400_dkac212-B27","doi-asserted-by":"crossref","first-page":"ii1","DOI":"10.1136\/thoraxjnl-2011-200598","article-title":"British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011","volume":"66","author":"Harris","year":"2011","journal-title":"Thorax"},{"key":"2022090713490037400_dkac212-B28","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1093\/cid\/cir531","article-title":"The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America","volume":"53","author":"Bradley","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2022090713490037400_dkac212-B29","doi-asserted-by":"crossref","first-page":"e72","DOI":"10.1093\/cid\/cis370","article-title":"IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults","volume":"54","author":"Chow","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2022090713490037400_dkac212-B30","doi-asserted-by":"crossref","first-page":"e964","DOI":"10.1542\/peds.2012-3488","article-title":"The diagnosis and management of acute otitis media","volume":"131","author":"Lieberthal","year":"2013","journal-title":"Pediatrics"},{"key":"2022090713490037400_dkac212-B31","doi-asserted-by":"crossref","first-page":"e262","DOI":"10.1542\/peds.2013-1071","article-title":"Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 Years","volume":"132","author":"Wald","year":"2013","journal-title":"Pediatrics"},{"key":"2022090713490037400_dkac212-B32","article-title":"Guideline cg191 Pneumonia in adults: diagnosis and management [Guidance withdrawn by NICE and currently under review]","author":"NICE","year":"2014"},{"key":"2022090713490037400_dkac212-B33","article-title":"Guideline ng179. Sinusitis (acute): antimicrobial prescribing","author":"NICE"},{"key":"2022090713490037400_dkac212-B34","article-title":"Guideline ng91. Otitis media (acute): antimicrobial prescribing","author":"NICE"},{"key":"2022090713490037400_dkac212-B35","article-title":"Guideline ng138. Pneumonia (community-acquired): antimicrobial prescribing","author":"NICE"},{"key":"2022090713490037400_dkac212-B36","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and treatment of adults with community-acquired pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America","volume":"200","author":"Metlay","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2022090713490037400_dkac212-B37","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1093\/jac\/49.1.31","article-title":"Antibiotic therapy of community respiratory tract infections: strategies for optimal outcomes and minimized resistance emergence","volume":"49","author":"Ball","year":"2002","journal-title":"J Antimicrob Chemother"},{"key":"2022090713490037400_dkac212-B38","article-title":"Access barriers to antibiotics","author":"Centre for disease dynamics, economics and policy","year":"2019"},{"key":"2022090713490037400_dkac212-B39","doi-asserted-by":"crossref","first-page":"135","DOI":"10.2471\/BLT.17.199562","article-title":"Medicines quality assurance to fight antimicrobial resistance","volume":"96","author":"Nwokike","year":"2018","journal-title":"Bull World Health Organ"},{"key":"2022090713490037400_dkac212-B40","article-title":"Substandard and falsified medical products","author":"WHO"},{"key":"2022090713490037400_dkac212-B41","first-page":"DC17","article-title":"Antimicrobial resistance in clinical isolates of Streptococcus pneumoniae: mechanisms and association with serotype patterns","volume":"12","author":"Peela","year":"2018","journal-title":"J Clin Diagn Res"},{"key":"2022090713490037400_dkac212-B42","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/S1473-3099(11)70054-8","article-title":"Non-prescription antimicrobial use worldwide: a systematic review","volume":"11","author":"Morgan","year":"2011","journal-title":"Lancet Infect Dis"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/77\/Supplement_1\/i10\/45740885\/dkac212.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/77\/Supplement_1\/i10\/45740885\/dkac212.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T13:49:33Z","timestamp":1662558573000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/77\/Supplement_1\/i10\/6692265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,6]]},"references-count":42,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2022,9,6]]},"published-print":{"date-parts":[[2022,9,6]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkac212","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,9,6]]},"published":{"date-parts":[[2022,9,6]]}}}