The increased over-the-counter supply of antibiotics in many countries including India, is worsening antibiotic resistance globally, finds a study highlighting an urgent need for better enforcement of laws.

The study found that between 2000 and 2010, the consumption of antibiotics increased globally from 50 billion to 70 billion standard units. A majority of overall increase occurred in India, China, Brazil, Russia and South Africa. "This overuse of antibiotics could facilitate the development and spread of antibiotic resistance. In India, for example, about 57,000 neonatal sepsis deaths occurring annually are due to antibiotic-resistant infections," said Emmanuel Adewuyi, from the Queensland University of Technology in Australia.

It accounts for more than two million infections and 23,000 deaths annually in the US, and around 25,000 deaths in Europe each year. "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," Adewuyi added. For the study, published in The Journal of Infection, the team analysed studies from 24 countries.

The study found that antibiotics supplied without prescription were largely for the treatment of acute and self-limited conditions such as upper respiratory tract infections and gastroenteritis."Many were also broad-spectrum antibiotics like amoxicillin, azithromycin and others which increase the risk of development of difficult-to-treat infections like the deadly methicillin resistant Staphylococcus aureus," Adewuyi said.

"Such practice not only predisposes patients to inappropriate drug and dose choices, it portends great risks for the development and spread of resistant organisms, masking of diagnosis as well as delayed hospital admissions," said Asa Auta from the University of Central Lancashire in Britain. "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," Adewuyi noted.