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New Delhi: Penicillin, one of the oldest known antibiotics to humankind, is set to make a comeback in India. The Modi government is planning to revive its manufacture, five years after it went out of production due to unrealistic price controls.

The decision was taken after doctors across the country requested the central government to procure this crucial antibiotic critical to preventing Strep A bacterial infection — which can lead to serious complications such as rheumatic fever and rheumatic heart disease if left untreated.

The Department of Health Research (DHR), led by Dr Balram Bhargava, had informed the Ministry of Health and Family Welfare (MoHFW) that India needs more than 13,000 million doses of penicillin in the next three years — 600 million doses of injectable penicillin (Benzathine) and 12,600 million tablets of oral penicillin (phenoxymethyl).

A DHR committee, including senior officers from the health ministry, Department of Pharmaceuticals (DoP) and National Pharmaceutical Pricing Authority (NPPA), had deliberated over the requirement of penicillin and suggested that the drug be manufactured under the Make in India initiative.

“India has to invest in the procurement and manufacturing of the oral and injectable long acting penicillin to ensure quality assured antibiotics for primary and secondary prevention,” the committee wrote in its letter dated 20 September, a copy of which has been accessed by ThePrint.

Government to procure penicillin for three years

The DHR’s letter, addressed to Manoj Jhalani, Additional Secretary & Director, National Health Mission, tells the government that “use of penicillin should be taken up as a program by the ministry”. The letter also highlights how penicillin had become non-viable and its manufacturing was stopped due to an increase in the cost of raw material.

The government will now procure penicillin for three years and give it to all children aged 5 to 15 years who suffer from sore throat, at least once.

It is estimated that India currently has 13.17 million patients of rheumatic fever and rheumatic heart disease who need injectable doses of penicillin. For each patient to get the required number of dose, the committee has advised “every four weeks dose for 52 weeks which is equal to 172 million doses”. A round-off figure of 200 million injectable doses per year and 600 million for three years has hence been estimated and shared with the ministry.

In rheumatic heart disease, permanent damage to the heart valves is caused by a fever that usually begins with a strep throat infection by the bacteria Streptococcus — which can be effectively treated with penicillin.

For oral penicillin, assuming five episodes of sore throat takes place in each child between the ages of 5 and 15 per year, one of them is likely to suffer from Strep A bacterial infection requiring antibiotics.

“Dose per sore throat of 500 mg tablet for 3 doses per day for 5 days (which means 15 doses), the total course needed for estimated 280 million patients will be 4,200 million doses per year,” the committee said.

For three years, the total required dosage would be 12,600 million tablets.

Also read: Superbugs on the rise, India must regulate antibiotics to avert disaster

What is penicillin?

Alexander Fleming, a Scottish researcher, discovered penicillin in 1928. Known as a “careless” laboratory technician, Fleming had discovered the antibiotic accidentally when “he returned from a two-week vacation to find that a mold had developed on an accidentally contaminated staphylococcus culture plate. Upon examination of the mold, he noticed that the culture prevented growth of staphylococci”.

Staphylococci is a type of bacteria responsible for life threatening diseases such as pneumonia, meningitis and boils.

Penicillin had become the most widely used antibiotic in the world to treat many types of infections caused by bacteria – in the stomach and intestines, blood, bladder and kidneys.

Also read: Antibiotic resistance is not new – it existed long before people used drugs to kill bacteria


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