India May Be Overusing ‘Watch’ Antibiotics, Global Lancet Study Finds

The Superbug Time Bomb: Why India’s Dependence on First-Line Antibiotics is a Dangerous Wager

We’ve all had it: waking up with a sore throat or a bad cough and heading straight to the local chemist for a quick fix. But a landmark study published in The Lancet Public Health shows that this everyday habit is part of a much scarier, nationwide crisis. India is vastly overusing potent, high-end antibiotics, leaving safer, basic medications on the shelf.

The AWaRe Trap: Why We Are Taking the Wrong Drugs

To help doctors and countries in the fight against superbugs, the World Health Organisation (WHO) neatly categorises antibiotics into three groups, known as the AWaRe framework:

1. Access: The reliable workhorses of everyday use (like regular amoxicillin) for common infections with a low likelihood of creating resistance.

2. Watch: More potent, broader drugs that carry a high risk of breeding resistant bacteria and should only be used when absolutely necessary.

3. Reserve: The last line of defence, locked away for the nightmare infections that nothing else can touch.

Lancet data suggests that India’s prescribing habits have turned this safety model on its head. The total use of antibiotics is 18.3 doses per 1,000 people per day, well above the optimal target of 14.7.

What people are taking is even more disturbing. Instead, India uses strong “Watch” antibiotics (9.3 doses) rather than essential “Access” drugs (which should account for more than half of all use). Safe first-line treatments now represent only 27% of total consumption.

Why We Should Be Afraid

When we use heavy-duty broad-spectrum antibiotics for routine bugs, self-medicate or buy strong pills over-the-counter without a proper diagnosis, we are giving bacteria a masterclass in survival.

This accelerates antimicrobial resistance (AMR) at breakneck speed, turning once-simple infections into untreatable superbugs. Experts have warned that routine surgeries and minor cuts could soon become life-threatening risks unless we clamp down on indiscriminate prescriptions, tighten up over-the-counter rules and get back to basics.