India: The Antibiotic Nation

How India became the antibiotics capital of the world and laid the wonder cure to waste.

- Lhendup G Bhutia

“The time may come when penicillin can be bought by anyone in the shops. There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.” – Alexander Fleming at his 1945 Nobel Prize lecture.

In 2009, a 59-year-old Swede of Indian origin began visiting a hospital in Orebro, a small city about 160 km away from Stockholm. The patient, a diabetic male, needed treatment for bed sores and urinary tract infection. He had recently returned from India, where he had developed an abscess in his buttocks and had been hospitalised, first in Ludhiana and later in Delhi. He had undergone a surgery in Delhi, recovered and returned to Sweden.

So far, so good. The development of the abscess wasn’t particularly unique. Diabetics are known to be susceptible to it. The bed sores and the urinary tract infection, one could understand, he probably acquired from his stay in the Delhi hospital. But there was something odd about his infection. No antibiotic seemed to work on it. Not even carbapenems, the strongest class of antibiotics currently known to man.

A routine urine test threw up something extremely unusual. The bacterium causing the infection, as the doctors analysing the case wrote in the journal Antimicrobial Agents and Chemotherapy, was the familiar Klebsiella pneumonia