• A large percentage of students responded to having consulted doctors/other health professionals for their ailments. A small number resorted to self medication.
• Information by the doctors to the patients is lacking. Doctors may inform about the disease but at the same time about the appropriate use of medicines – dose, frequency and duration of the treatment - and other related aspects are not imparted to the patients unless such information was specifically sought for.
• Students were also not aware as to what they are supposed to inform to the doctors at the time of consultation viz. the medication they are taking; allergy to any medicine and seek information from the doctor about the appropriate use of medicine.
• At the time of purchasing the medicines, a very small percentage carry the prescription with them and cross checks the name of the medicine with the prescription or verify the date of expiry.
• Majority do not ask for the bill of purchase of medicines.
• A minimum percentage only admitted to having received the instructions with the medicines before using them.
• The knowledge of students about the storage of medicines at home was inadequate. The knowledge of carrying the medicines to school was inappropriate.
• There is a tendency to use the left over medicines by the students on their own at their discretion.
• Lack of knowledge of students about the antibiotics is alarming. Students are not aware as to what antibiotics are and for what they are used, leave alone their appropriate usage.

1. coordinated monitoring of antimicrobial resistance and antimicrobial use in communities as well as hospitals; and
2. develop appropriate intervention to improve antimicrobial use and therefore contain the development of antimicrobial resistance.

The mechanism set up to monitor the products of the project was a multi-disciplinary Advisory Committee which was serviced by the Delhi Society for Promotion of Rational Use of Drugs (DSPRUD).

A meeting of the AMR Advisory Committee with the Principal Investigators from the three centres (Delhi, Mumbai and Vellore) was held at the Bharatiya Vidya Bhavan, New Delhi, on December 15, 2008, in which progress of the project was reviewed and it was noted that

1. all the three centres had completed Phase I (to set up a surveillance system)
2. two of the three centres had completed Phase II (to refine the surveillance system and undertake qualitative investigation)
3. the third centre had just completed data collection for Phase II.

Among the major suggestions that emanated in this meeting were:

1. There was unanimity about the urgent need to reduce inappropriate use of anti microbial agents.
2. An effective intervention would need to be evolved bringing in all the major stakeholders of whom the prescribers and the community (patients) were the most important.
3. A two-pronged approach involving the delivery of targeted messages to consumers (via different groups in the community) through their local prescribers and dispensers (involving them as co-investigators) was discussed. Vellore had developed a proposal along these lines.
4. It was felt to be the only way of truly involving all concerned stakeholders, since the qualitative investigation had revealed a lack of interest on the part of private practitioners and pharmacy shop owners to participate in continuing medical education.
5. It was suggested that a proposal should be made to the Government of India to alert them on the dangers of inappropriate use of anti microbial resistance duly substantiated by the evidence that had been gathered on inappropriate use of antibiotics in actual surveys in the pilot project.