Do You Self-Medicate?

Dear Reader,

I was sick through most of the reporting for this story. It started with sniffles and eventually turned into a full-blown infection. My doctor prescribed antibiotics, and they worked.

The irony did not escape me.

Because as I learned while reporting this piece, nearly one in two antibiotic prescriptions in India may be unnecessary.

Not just that, potentially harmful.

Recent research from the Indian Council of Medical Research and The Lancet points to a sharp rise in antibiotic resistance across India. The Lancet study found that 83.1% of certain bacterial samples collected in India showed resistance to commonly-used antibiotics, the highest proportion among the countries studied.

In simple terms, bacteria are learning to outsmart the drugs designed to kill them.

Modern medicine depends heavily on these drugs. Doctors use antibiotics to treat everything from urinary tract infections to pneumonia. Surgeons rely on them to prevent post-operative infections.

This isn’t a niche product. The domestic antibiotics market is now worth nearly three billion dollars, reflecting just how widely people use these medicines.

If antibiotics lose effectiveness, modern medicine comes to a standstill. 

“Globally, a few million people are dying from antimicrobial resistance,” said Dr Ranga Reddy, president of the non-profit Infection Control Academy of India. “Within India, we don’t have hard and fast data, but this is likely causing a few lakh deaths each year.”

Dr Reddy uses the broader term antimicrobial resistance, which includes resistance to antibiotics, antivirals, antifungals and antiparasitic drugs. But in India, most of the current burden–and most of the deaths–are due to antibiotic resistance in bacteria.

While antibiotic resistance is a global issue, certain factors make it especially concerning here in India.

First, some inexperienced doctors, sometimes under duress by patients, overprescribe antibiotics. Second, some patients turn to quacks or self-medicate, or don’t complete the entire course of antibiotics. Third, farmers sometimes overuse antibiotics to cure infection and to promote growth. 

When I visited chemist shops in central Mumbai, pharmacists told me they ask new customers for prescriptions. But if someone insists, or if they are familiar with the customer, they often dispense antibiotics anyway. One pharmacist added that some customers do not complete the full course because they cannot afford it.

Regardless of the reason, the biological effect remains the same. Partial exposure allows the most resilient bacteria to survive and multiply. Over time, those bacteria can evolve further, and eventually become resistant to multiple drugs. 

This is not a distant, abstract crisis. It is unfolding right now across the country. And while policy and enforcement matter, everyday decisions matter too. Decisions by doctors, by chemists and by us.

In the latest episode of The Signal Brief, I speak to physicians, pharmacists and industry experts to understand how we got here and what needs to change before we run out of options.

You can find The Signal Brief on YouTube, Spotify, and Apple Podcasts.

Thank you once again for listening and supporting us. We’d love to hear from you; write to us at [email protected] or find us on Instagram or X at @thesignaldotco.

Best,
Kudrat
on behalf of The Core

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