Leptospirosis cases have been spiralling in the State, with nearly 2,300 suspected cases and some 125 suspected deaths reported so far this year.
However, the WHO-recommended drug for treating seriously ill leptospirosis patients going into multi-organ failure — Benzylpenicillin injection — is not available either in the open market or in government hospitals in the State.
In the absence of the drug, doctors prescribe third generation antibiotics to treat leptospirosis, which are unaffordable to the poor.
“Benzylpenicillin is a cheap, time-tested, and effective drug included on the essential medicines list. But the drug is no longer in supply anywhere. Pharma companies are pushing expensive cephalosporin group of antibiotics instead,” Santhosh, a physician, said.
“When contacted, Hindustan Antibiotics Ltd., a public sector company which supplies the drug, said they were no longer importing or supplying the drug,” he said.
A pharma retailer said that many low-cost drugs such as Benzylpenicillin had disappeared from the market in the past few months and that no pharma dealer or distributor wanted to invest in marketing a drug which had low profit margins. There were a number of branded new generation antibiotics, widely prescribed by doctors, he said.
K.G. Revikumar, former Professor of Clinical Pharmacy at the Thiruvananthapuram medical college hospital, said Benzylpenicillin had been forced into being an “orphan drug” (drugs which are used for treating rare diseases or those which have no sponsors because the market is small and does not bring in much profit), partly because of the entry of third generation cephalosporins and also because of the changes in medical practice.
Penicillin may cause allergic reaction in some and the injection has to be administered under supervision and patients are observed for reactions. “The scare built up around anaphylactic reactions makes doctors prefer expensive antibiotics which are marketed as handy and safe,” Dr. Revikumar said.
Benzylpenicillin is one among the Category 1 drugs that the Kerala Medical Services Corporation had to re-tender twice as there were no bidders for it.
However, Ashwini kumar, Professor of Medicine, Thiruvananthapuram medical college hospital, said the hospital had ample stocks of Benzylpenicillin and as the drug of choice for leptospirosis, it was being administered for patients on a daily basis.
