A Life-Saving Discovery Under Threat
When Alexander Fleming discovered penicillin in 1928, it transformed medicine. Infections that had previously been death sentences became treatable. But nearly 100 years on, we face a growing crisis: the bacteria are fighting back.
Antimicrobial resistance (AMR) — the ability of bacteria to survive and multiply despite antibiotic treatment — is now recognised by the WHO as one of the greatest threats to global health, food security, and development.
India bears a disproportionate burden. High rates of antibiotic use, easy over-the-counter availability, poor sanitation in some areas, and widespread self-medication have made India one of the world's largest consumers of antibiotics — and a hotspot for resistant bacteria.
Understanding antibiotics — what they are, how they work, and critically, how to use them responsibly — is essential for every person.
What Are Antibiotics?
Antibiotics are medicines that kill bacteria or stop them from reproducing. They are effective only against bacterial infections.
Common bacterial infections that may require antibiotics:
- Strep throat (Group A Streptococcus)
- Urinary tract infections (UTIs)
- Pneumonia (bacterial)
- Skin infections (cellulitis, impetigo)
- Some ear and sinus infections
- Tuberculosis (TB)
- Typhoid fever
What Antibiotics Cannot Treat
Antibiotics have no effect on:
- Viruses — including the common cold, flu, COVID-19, dengue, and most sore throats
- Fungal infections — these require antifungal medicines
- Parasitic infections — these require antiparasitic medicines
This is the most common misconception that leads to antibiotic misuse. If your doctor does not prescribe antibiotics for your cold or flu, they are doing the right thing.
How Bacteria Become Resistant
Bacteria are living organisms that evolve rapidly. When exposed to antibiotics:
- 1Most bacteria die
- 2A small number may have natural mutations that allow them to survive
- 3These survivors reproduce, passing on resistance genes
- 4Over time, the entire population may become resistant
This process is accelerated by:
- Taking antibiotics when they aren't needed (viral infections)
- Not completing the full course
- Taking the wrong antibiotic for the infection
- Using old or expired antibiotics
- Using antibiotics meant for livestock
The Rules of Responsible Antibiotic Use
1. Never take antibiotics without a prescription
Your doctor determines whether you need antibiotics based on your symptoms, examination findings, and sometimes lab tests. Self-diagnosing and self-medicating with antibiotics is dangerous.
2. Always complete the full course
Even if you feel better after 2–3 days, continue the antibiotic for the full prescribed duration. Stopping early allows bacteria to survive and develop resistance.
3. Take the right dose at the right time
Antibiotics must maintain a consistent level in your bloodstream. Missing doses or taking half doses creates periods of low drug concentration — ideal conditions for resistant bacteria to emerge.
4. Never share antibiotics
An antibiotic prescribed for your infection may not be appropriate for someone else's infection. Sharing prescription medicines is both illegal and dangerous.
5. Never save antibiotics for later use
Different infections require different antibiotics. Using leftover antibiotics from a previous illness can lead to wrong treatment and contribute to resistance.
6. Report if the antibiotic doesn't seem to be working
If you see no improvement after 2–3 days of antibiotic therapy, contact your doctor. You may have a resistant infection or a non-bacterial condition that doesn't respond to antibiotics.
Protecting Yourself from Resistant Infections
Prevention remains the best strategy:
- Wash hands regularly with soap and water
- Keep vaccinations up to date — vaccines prevent infections, reducing the need for antibiotics
- Practice food safety — cook meat thoroughly, avoid cross-contamination
- Avoid unnecessary hospital stays — hospitals are reservoirs of resistant bacteria
- Support infection control — if you or a family member is hospitalised, ask staff about infection control practices
India's Response to AMR
The Government of India has launched a National Action Plan on AMR (NAP-AMR) aligned with the WHO's global plan. Key pillars include:
- Restricting over-the-counter antibiotic sales
- Training healthcare providers in rational antibiotic prescribing
- Investing in surveillance to track resistant bacteria
- Developing new antibiotics
Pharmaceutical companies also play a role. Responsible manufacturers ensure antibiotics are not sold without prescriptions and invest in quality manufacturing that minimises the risk of subtherapeutic doses — a major driver of resistance.