The private sector clocked high levels of antibiotic prescription rates (412 per 1,000 persons per year), according to a new study by researchers at the Public Health Foundation of India (PHFI).

The highest rate was seen among children aged 0–4 years (636 per 1,000 persons) and the lowest in the age group 10–19 years (280 per 1,000 persons). The study is the first ever estimate of outpatient antibiotic prescription rates and patterns in the private sector and has been published this month in PLOS One titled “Outpatient antibiotic prescription rate and pattern in the private sector in India”. The authors used the 12­ month period (May 2013­ April 2014) medical audit data set and concluded that the prescription rates for certain classes are on a higher side in India as compared to the developed nations. The study said the percentage of prescriptions for wide­ spectrum antibiotics like cephalosporins and quinolones (38.2% and 16.3%)was significantly higher than the U.S. (14.0% and 12.7%)and Greece (32.9% and 0.5%). 

Unusually high prescription rates of beta­lactamspenicillins and cephalosporins in uncomplicated upper respiratory infections in children is in stark contrast to the prescription rates and pattern reported in Europe. India is considered to be one of the top users of antibiotics and there is a growing problem of antimicrobial resistance. The study noted that the per capita antibiotic consumption in the retail sector has increased by around 22% in five years from 2012 to 2016.

Though clinical guidelines on judicious antibiotic use explicitly mentions that they should not be prescribed for common cold, non-specific upper respiratory tract infection (URI), acute cough illness and acute bronchitis, the study shows a high rate of prescriptions for respiratory infections in primary care. The study highlighted that of the 519 million antibiotic prescriptions, the majority were dispensed for the diseases of the respiratory system (55%), followed by genitourinary system (10%) and symptoms, signs and abnormal clinical findings (9%); generally these infections are viral in origin and self limiting in nature.

Answer the following questions from the above passage-

Q1. What was the highest and lowest rate of  antibiotic prescription by the private sector? 

Q2. What was the title of the study published in PLOS by researchers at the public Health foundation of India (PHFI)? 

Q3. What was the percentage of prescriptions for wide spectrum antibiotics in India as compared to the developed nations? 

Q4. Mention the name of infections which are viral in origin and self limiting in nature? 

Q5.  What are the clinical guidelines on judicious use of antibiotics?