India's antibiotic sales slip, but misuse worries persist among experts

Antibiotic sales volumes in India have contracted since 2023, according to tracking data from pharmaceutical analytics firm Pharmarack, marking a potential shift in consumption patterns across the region's largest pharmaceutical market. However, the decline in unit sales does not necessarily signal improved stewardship in how these critical medicines are being used, specialists warn.

The reduction in sales volumes comes amid sustained concern about antimicrobial resistance (AMR), a growing public health threat that experts attribute largely to the inappropriate prescription and overuse of antibiotics. Industry observers note that falling sales figures provide an incomplete picture of prescribing behaviour, as they do not account for whether remaining usage follows clinical guidelines or represents cases of unnecessary administration.

India has faced particular scrutiny over antibiotic dispensing practices, with studies documenting high rates of over-the-counter sales and inappropriate use across both urban and rural areas. Regulatory bodies and medical associations have intensified efforts to curb indiscriminate prescribing, yet enforcement challenges persist, particularly in regions with limited healthcare infrastructure.

Experts emphasise that meaningful progress on antibiotic stewardship requires monitoring not only sales trends but also prescription patterns, patient adherence to treatment courses, and the prevalence of resistance in clinical settings. They stress that sustainable reductions in inappropriate use depend on coordinated efforts spanning healthcare providers, pharmaceutical distributors, and public awareness campaigns across India's diverse healthcare landscape.