India Among Nations Overusing Powerful Antibiotics, Global Lancet Analysis Reveals

The antibiotics we rely on to treat infections are slowly losing their power-and overuse is one of the biggest reasons why.

A new study published in The Lancet Public Health suggests that India may be overusing antibiotics, especially a group of powerful medicines known as "Watch" antibiotics. Researchers warn that this trend could speed up the spread of antibiotic resistance, making many common infections much harder to treat.

Antibiotic resistance happens when bacteria change over time and learn how to survive antibiotics. As a result, medicines that once killed bacteria stop working, allowing infections to continue spreading. According to the World Health Organization (WHO), antibiotic resistance has already been linked to more than 4.7 million deaths worldwide.

The researchers analyzed antibiotic use in 186 countries and found that 99% of them were overusing Watch antibiotics. These medicines are broad-spectrum antibiotics that should only be used for specific infections because they carry a higher risk of causing antibiotic resistance.

The WHO classifies antibiotics into three groups under its AWaRe system:

• Access antibiotics: First-choice medicines used to treat common infections with a lower risk of resistance.

• Watch antibiotics: Stronger antibiotics that should be used only when necessary because bacteria can become resistant more easily.

• Reserve antibiotics: Last-resort drugs used only for severe infections caused by highly drug-resistant bacteria.

Experts say antibiotic resistance is a major public health concern because it can make common infections like pneumonia or urinary tract infections difficult—or even impossible—to treat. It can also make surgeries, cancer treatment, and organ transplants riskier, as these procedures depend on effective antibiotics to prevent infections.

When standard antibiotics stop working, doctors may have to use stronger, more expensive medicines that often cause more side effects and may still not work well.

Researchers say antibiotics should only be taken when prescribed by a healthcare professional, and unnecessary use should be avoided to help slow the spread of antibiotic resistance and preserve these life-saving medicines for the future.

REFERENCE: Cook A, Cooper B, Thorn M et al.; Estimating optimal levels of WHO Access, Watch, Reserve (AWaRe) antibiotic use in 186 countries, territories, and areas on the basis of clinical infection and resistance burden; The Lancet Public Health, DOI: 10.1016/S2468-2667(26)00103-9