ANTIMICROBIAL RESISTANCE IN INDIA RISING

Why In News?

A study in The Lancet Public Health (2026) reveals that India consumes excessive volumes of "Watch" and "Reserve" antibiotics instead of safer, basic alternatives, with consumption reaching 18.3 Defined Daily Doses (DID). 

What are "Watch" and "Reserve" Antibiotics?

The World Health Organization (WHO) categorizes antibiotics under the AWaRe classification system to guide appropriate usage:

• Access Antibiotics: Serve as safe, affordable, first-choice treatments for common infections and carry a minimal risk of generating drug-resistant superbugs.

• Watch Antibiotics: Represent stronger, broad-spectrum drugs that clinicians must use selectively because they rapidly trigger bacterial resistance.

• Reserve Antibiotics: Function as "last-resort" life-saving medicines that healthcare providers reserve strictly for treating highly dangerous, multi-drug-resistant infections.

Why is the Rising Use of Reserve Antibiotics a Concern?

Accelerates Antimicrobial Resistance (AMR): Misusing strong antibiotics drives bacteria to develop physical shields and efflux pumps, mutating them into untreatable superbugs.

Depletes Future Treatment Options: Careless use of "Reserve" drugs strips them of their efficacy, leaving clinicians with no backup therapies during life-threatening emergencies.

Escalates Healthcare Costs: Drug-resistant infections prolong hospital stays and necessitate expensive alternative therapies, threatening to inflict global economic losses of up to US$412 billion by 2050. (Source: Lancet Study) 

Jeopardizes Modern Medicine: Routine medical procedures like cesarean sections, organ transplants, and cancer therapies become highly hazardous if protective antibiotics fail to work.

Major Drivers of Antibiotic Misuse in India

Unregulated Over-the-Counter Sales: Pharmacies easily dispense strong antibiotics without prescriptions, with over-the-counter sales reaching 45.5% in Andhra Pradesh according to a Toxics Link Study (2026).

Widespread Self-Medication: Poor public awareness drives 57% of consumers to share leftover antibiotics with family and friends. (Source: Toxics Link Study)

Inappropriate Clinical Prescriptions: Clinicians prescribe powerful drugs unnecessarily, with a National Centre for Disease Control (NCDC) (2021-22) survey showing that 57% of hospital prescriptions specify "Watch" antibiotics without prior diagnostic testing. 

Misuse for Viral Infections: Patients pressure doctors for quick-fix antibiotics to treat viral colds and flu, despite the drugs' inability to kill viruses.

Agricultural and Livestock Abuse: Farmers feed antibiotics to livestock to accelerate growth, which leaks these drugs into the environment and the human food chain.

Deficient Antimicrobial Stewardship: Hospitals fail to enforce strict protocols, leading doctors to prescribe 55% of antibiotics as precautionary prophylaxis rather than targeted cures.

Why AMR is a National and Global Challenge

Severe Public Health Threat: Drug-resistant diseases threaten to cause 10 million deaths annually by 2050 globally, while India reports 2.97 lakh deaths in 2019 directly linked to AMR. (Source: WHO)

Heavy Economic Burden: Resistant infections drain the financial resources of low- and middle-income countries that already struggle with high infectious disease loads.

Rapid Cross-Border Transmission: Pathogens bypass international borders easily through global travel and food trade networks.

Interconnected One Health Threat: AMR links human, animal, and environmental health, requiring a unified response across all sectors.

Way Forward

Enforce Rational Prescription Protocols: Mandate laboratory culture tests to identify specific pathogens before prescribing broad-spectrum drugs.

Clamp Down on Over-the-Counter Sales: Penalize pharmacies that sell antibiotics without valid prescriptions and fail to maintain proper sales logs.

Optimize Hospital Stewardship Programs: Restrict duplicate antibiotic therapies and eliminate unnecessary intravenous (IV) administrations for mild illnesses.

Expand AMR Surveillance Networks: Deploy advanced data tracking to map the spread of superbugs across Indian states.

Launch Public Awareness Campaigns: Educate citizens that antibiotics do not cure viral fevers or common colds.

Accelerate Research and Development: Fund novel antimicrobial research, such as the CSIR-Indian Institute of Integrative Medicine study proving that the THCBD compound from cannabis acts as a potent antibiotic against drug-resistant Staphylococcus aureus.

Implement Drug Bans Strictly: Strongly implement the recent ban on 156 fixed-dose combinations (FDCs) to permanently remove useless, risky, and resistance-causing medicines from the Indian market

Conclusion

Combating the antimicrobial resistance crisis requires strict enforcement of clinical guidelines, regulatory oversight of drug sales, and a unified One Health strategy to preserve the efficacy of life-saving medicines for future generations.

Source: indianexpress