Antibiotic Resistance in India: Drivers and Opportunities for Action

Citation: Laxminarayan R, Chaudhury RR (2016) Antibiotic Resistance in India: Drivers and Opportunities for Action. PLoS Med 13(3): e1001974. doi:10.1371/journal.pmed.1001974
Published: March 2, 2016

Summary Points

  • Antibiotic use is a major driver of resistance. In 2010, India was the world’s largest consumer of antibiotics for human health.
  • Access to antibiotics is rising, which portends well for the large proportion of India’s population that has thus far had poor access to these life-saving drugs.
  • The convergence of factors such as poor public health infrastructure, rising incomes, a high burden of disease, and cheap, unregulated sales of antibiotics has created ideal conditions for a rapid rise in resistant infections in India.
  • Over-the-counter, nonprescription sales of carbapenems in India are among the highest in the world and contribute to growing carbapenem resistance among Gram-negative organisms.
  • Improving regulation of drug production and sales, better managing physician compensation, and encouraging behavior change among doctors and patients are of immediate priority.


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