Antibiotic Resistance: Why Misusing Medicines Is Dangerous

A child has a fever and a runny nose. The parents go to a nearby medical shop, describe the symptoms and come home with a strip of antibiotics. Three days later the child is better, and the leftover tablets go into a drawer “for next time”.

This happens in homes across India every day. It may seem sensible, but habits like this feed one of the biggest threats to modern medicine that health experts know of: antibiotic resistance.

When antibiotics stop working, infections that were once easy to cure become difficult, expensive or even impossible to treat. In this article we explain what antibiotic resistance is, why it is increasing, how misuse makes it worse, and what each of us can do about it.

Please note: this article is for general information only and is not medical advice. Always consult a qualified health professional before taking any medicine.

What are antibiotics?

Antibiotics are drugs that either destroy bacteria or inhibit their growth. Since penicillin came into wide use in the 1940s, antibiotics have saved millions of lives. They are used to treat infections such as pneumonia, typhoid, tuberculosis and urinary tract infections.

Antibiotics also make much of modern medicine possible. Surgery, Caesarean deliveries, cancer chemotherapy and organ transplants all depend on antibiotics to prevent and treat infections.

There is one thing to remember: antibiotics work only against bacteria. They do not work against viruses.

The common cold, most coughs and sore throats, flu, COVID-19, dengue and chickenpox are all caused by viruses. Taking antibiotics for them will not help you get better. It only exposes the bacteria in your body to antibiotics for no reason.

What is antibiotic resistance?

Antibiotic resistance happens when bacteria change so that the medicines designed to kill them no longer work. The bacteria survive the drug and keep multiplying.

It is important to understand that it is the bacteria that become resistant, not the person. But resistant bacteria can spread from one person to another.

Bacteria that resist several antibiotics at once are often called superbugs.

Antimicrobial resistance (AMR) is the wider term. It covers bacteria, viruses, fungi and parasites that resist the medicines used against them. This article focuses on bacteria and antibiotics.

How does resistance develop?

Think of an infection as a crowd of bacteria. An antibiotic kills most of them easily, but a few may carry small genetic differences that help them survive the drug.

When you take an antibiotic, the weaker bacteria die, while the tougher ones survive, multiply and pass on their resistance genes. Because bacteria multiply very fast, this natural selection happens quickly.

Bacteria can also pass resistance genes directly to one another, even between different species. This is one reason resistance can spread so quickly through hospitals, farms and the environment.

Every use of an antibiotic puts some pressure on bacteria to become resistant. This cannot be avoided completely, even when antibiotics are used correctly. The aim is to use them only when they are truly needed, so that they keep working.

How big is the problem?

The figures are alarming.

According to a study published in The Lancet in 2024 by the Global Research on Antimicrobial Resistance (GRAM) project:

• antimicrobial resistance directly caused about 1.14 million deaths worldwide in 2021;
• it was associated with about 4.71 million deaths in the same year.

Without action, the study projects that AMR could directly cause around 39 million deaths between 2025 and 2050, roughly three deaths every minute. South Asia, including India, is expected to be the worst affected, with an estimated 11.8 million deaths directly attributable to AMR over the same period. Older people are especially at risk: AMR deaths among people aged 70 and above rose by more than 80 per cent between 1990 and 2021.

In October 2025, the World Health Organization’s Global Antibiotic Resistance Surveillance (GLASS) report found that:

• about one in six laboratory-confirmed bacterial infections worldwide were resistant to common antibiotics;
• in the WHO South-East Asia Region, which includes India, the figure was about one in three;
• more than 40 per cent of E. coli and more than 55 per cent of Klebsiella pneumoniae samples were resistant to third-generation cephalosporins, which are commonly used first-line drugs;
• between 2018 and 2023, resistance increased in more than 40 per cent of the drug–bacteria combinations monitored.

How misuse drives resistance

Some of our everyday habits help resistant bacteria to spread.

1. Taking antibiotics for viral infections

This is the most common kind of misuse. Antibiotics do not cure colds, flu or most coughs and sore throats. Taking them for these illnesses only exposes harmless bacteria in the body to the drug and helps resistant strains survive.

2. Self-medication

In many places, antibiotics are sold without a prescription, on the advice of friends, relatives or the shopkeeper. This often means the wrong antibiotic, the wrong dose or the wrong length of treatment, all of which encourage resistance.

3. Not taking antibiotics as prescribed

Some patients stop taking the medicine as soon as they feel better. Others keep taking it for longer than prescribed, “just to be safe”. The right approach is to follow your doctor’s instructions on the dose, timing and length of treatment, and to ask your doctor before making any change.

4. Using leftover or shared antibiotics

Tablets left over from an earlier illness, or a family member’s prescription, may be the wrong drug for a new infection, and there are usually not enough for a full course.

5. Pressure on doctors

Patients sometimes expect an antibiotic and feel dissatisfied without one. This pressure can lead to unnecessary prescriptions. If your doctor says you don’t need an antibiotic, trust that advice.

6. Poor infection control

When handwashing, sanitation and hospital hygiene are poor, resistant bacteria spread more easily from person to person.

One Health: the link between people, animals and the environment

Antibiotic resistance is not only a human health issue. Antibiotics are also given to poultry, livestock and farmed fish, both to treat disease and, in the past, to make animals grow faster or to prevent disease in crowded conditions.

Misuse on farms allows resistant bacteria to develop in animals and then reach people through food, water, soil and direct contact. Antibiotic residues and resistant bacteria can also enter rivers and soil through waste from farms, hospitals and drug factories.

This is why scientists use the One Health approach, which recognises that the health of people, animals and the environment is closely connected.

India has taken an important step in this direction. In July 2019, the Union Health Ministry banned the manufacture, sale and distribution of colistin and its formulations for use in food-producing animals, poultry, aquaculture and animal feed supplements. Colistin is a “last-resort” antibiotic, used for infections that other drugs cannot cure.

The message for farmers is simple: use antibiotics only when prescribed by a qualified veterinarian, give the recommended dose, observe the withdrawal period (the time after treatment during which milk, eggs, meat or fish must not be sold), and never use antibiotics to make animals grow faster.

What is India doing?

India launched its first National Action Plan on Antimicrobial Resistance (NAP-AMR) in 2017, covering the period up to 2021. The Union Health Minister released NAP-AMR 2.0 on 18 November 2025, during World AMR Awareness Week. The new plan covers 2025 to 2029 and includes separate plans, targets and budgets for each of the ministries involved.

India also runs awareness campaigns. One of them is the Red Line campaign, which asks people to look for a vertical red line on medicine packs. The red line means the medicine is prescription-only and should not be bought over the counter.

What you can do

Everyone’s choices matter. These simple steps make a real difference:

• Don’t ask for antibiotics for colds, flu or most coughs and sore throats. Ask your doctor what is causing the illness instead.
• Take antibiotics only when prescribed by a qualified doctor.
• Follow the prescription exactly. Don’t skip doses, stop early or continue longer without your doctor’s advice.
• Never share antibiotics or use leftovers. Ask your pharmacist how to dispose of unused medicines safely.
• Look for the red line on medicine packs, and don’t buy such medicines without a prescription.
• Prevent infections in the first place. Wash your hands with soap, drink safe water, cook food properly, and keep your family’s vaccinations up to date.
• If you keep animals, use antibiotics only on a vet’s advice and follow withdrawal periods.

Common myths and facts

Myth	Fact
Antibiotics cure colds and flu	Colds and flu are caused by viruses; antibiotics don’t work on them
A stronger antibiotic works faster	The right antibiotic is what matters; “stronger” or newer drugs should be saved for when they are needed
If I feel better, I can stop	Follow the prescription exactly and ask your doctor before stopping
Leftover antibiotics are useful for next time	They may be the wrong drug and not a full course
Resistance only matters to people who take lots of antibiotics	Resistant bacteria spread, so everyone is affected
It’s only a hospital problem	Resistance spreads through communities, food, farms and the environment

Conclusion

Antibiotics are among the most important medicines ever discovered, but they are losing their power. Every unnecessary or incorrect use gives bacteria another chance to adapt. Global studies now estimate that drug-resistant infections directly cause more than a million deaths a year, and South Asia is expected to bear the heaviest burden in the coming decades.

The solution does not depend only on new drugs or government plans. It also depends on our everyday choices: not demanding antibiotics for viral illnesses, never self-medicating, following prescriptions exactly, preventing infections, and using antibiotics responsibly in animals. Used wisely, antibiotics can go on saving lives for generations to come.