Antibiotic stewardship in primary healthcare – key to addressing growing antibiotic resistance in India

In countries all over the world, the overuse and misuse of antibiotics is driving the development of antimicrobial resistance (AMR) – putting an “unnatural selective pressure” on bacteria and fuelling the rise of drug-resistant superbugs. 

In theory, Indian legislation requires that all antibiotics are purchased with a prescription. In reality, a high number of sales take place without a formal prescription from a qualified healthcare provider. In 2021, for example, a qualitative study in two Indian states found antibiotics to be commonly available through over-the-counter (OTC) retail pharmacy sales, with others reporting similar findings. Of particular concern, is the number of antibiotics dispensed by unqualified providers, the amount of inappropriate prescriptions, and the level of demand from patients looking to self-medicate, and insisting on an OTC service. This situation is compounded by a general lack of awareness (public and professional) as to the impact such practices have on the evolution of AMR.