Saving millions of lives from illnesses, antibiotics have long been praised as one of the best successes in contemporary medicine. However, these life-saving medications are in increasing danger from remarkably fast-evolving and adaptable microorganisms. An alarming global increase in antibiotic-resistant illnesses results from these “superbugs” progressively outwitting the very antibiotics meant to kill them.
A 2021 study in The Lancet claims that antibiotic-resistant microorganisms caused 1.14 million fatalities worldwide alone. The terrible truth is that many of these deaths happened in illnesses for which medicines proved useless. Antibiotics have been the first line of protection against serious diseases for decades; nevertheless, the emergence of resistance threatens to reverse decades of advancement.
Why Is Antibiotic Resistance Causing Problems in India?
Among the nations most affected by antimicrobial resistance (AMR) is India. Antibiotic-resistant illnesses claimed around 300,000 lives in India in 2019; each year, almost 60,000 babies die from these infections as well. These figures highlight how urgently AMR must be addressed, particularly in nations with significant infection loads and where antibiotic abuse is common.
Though the situation is terrible, some optimism is yet to come. Developed locally, several interesting novel medications show promise in combating these superbugs. These developments give some promise for maintaining the potency of current medicines and in the fight against drug-resistant infections.
How Is Enmetazobactam Changing Antibacterial Therapy?
Developed by Chennai-based Orchid Pharma, Enmetazobactam is among the most exciting new drugs. The first antibacterial developed in India and approved by the US Food and Drug Administration (FDA) is enmetazobactam. Unlike targeting the bacteria directly, this injectable medicine targets their defense systems.
“Enmetazobactam works by binding tightly to enzymes, like beta-lactamase, which bacteria produce to destroy antibiotics,” one of the main co-inventors of the medicine noted. “The drug lets antibiotics effectively kill the bacteria by neutralizing these enzymes, preventing easy resistance triggers.”
This method helps maintain the potency of antibiotics such as carbapenems, regarded as the last resort against resistant diseases. Comprising more than 1,000 participants, clinical studies across 19 nations have shown the drug’s efficacy. “The drug has shown remarkable potency against bacteria that have evolved over the years,” the co-inventor said. Currently reserved for hospitalized critically ill patients only, enmetazobactam is given intravenously and is not sold over the counter.
What fresh antibiotics do Zaynich and Nafithromycin offer?
Mumbai-based Wockhardt, testing two interesting antibiotics, Zaynich and Nafithromycin, also represents another significant development.
After 25 years of research, Zaynich is under Phase-3 testing and should be released the following year. The ground-breaking, one-of-its-kind novel antibiotic meant to fight all major superbugs, Wockhardt’s original chairman defined Zaynich as In India, where thirty severely ill patients who were unresponsive to conventional antibiotics lived after receiving Zaynich, the medicine has already been used compassionately. “This would make India proud,” the founder chairman said.
Also under development is Nafithromycin, under MIQNAF, a three-day oral therapy for bacterial pneumonia contracted in the community. Although conventional treatments for this illness have up to 60% resistance, Nafithromycin shows a 97% success rate. Its studies are scheduled to finish next year, and in late 2025, the medicine might be sold commercially.
In what ways is Bugworks Research addressing the AMR crisis?
Smaller biopharma businesses have been prompted to intensify their research on novel antibiotics by the escalating threat of AMR. One such company is Bugworks Research, a Bengaluru-based business working with the Geneva-based Global Antibiotic Research and Development Partnership (GARDP). They focus on creating a new class of antibiotics to fight major, drug-resistant illnesses.
“This drug is still in early Phase-1 trials, and it will take another five to eight years before it’s ready for market,” Bugworks’ CEO remarked. “Big money is in cancer and diabetes medications, not antibiotics; hence, few inventions exist. Antibacterial resistance is not a top priority for pharmaceutical corporations.”
India’s contribution to this worldwide project is vital. “Several companies have funded us, but less than 10% of our funding comes from India,” the CEO said, underlining the necessity of increased assistance from within the nation.
What Recent Research Reveals About Antibacterial Resistance in India?
The situation in India is still concerning, even with the development of several promising new drugs. Comprising about 100,000 bacterial cultures from 21 specialized care facilities, the 2023 surveillance report published by the Indian Council of Medical Research (ICMR), Particularly to bacteria like E. coli, Klebsiella pneumoniae, and Acinetobacter baumannii, the results show a worrisome increase in antibiotic resistance.
Typically discovered in the intestines and linked to tainted food, E. coli was the most typically isolated pathogen. Resistance to Klebsiella pneumonia, which can cause meningitis, pneumonia, and bloodstream infections, has alarmingly increased. Targeting patients in intensive care facilities, Acinetobacter baumannii is a multidrug-resistant bacteria that is equally troubling. Antibiotic efficacy against these infections has drastically dropped; some medications are less than 15% effective.
“Some key antibiotics are no longer effective, especially against Klebsiella and E. coli,” noted an expert. “It’s like doing whack-a-mole with germs. They change at a shockingly rapid speed; we are continually catching up.
Why Should Antibiotic Prescription Guidelines Concern India?
Drug-resistant superbugs emerging in India are not just the outcome of bacterial evolution but also related to the policies followed in the healthcare system. The issue is partly caused by improper prescribing habits, especially the general use of broad-spectrum antibiotics. Although these antibiotics target a broad spectrum of bacteria, adverse effects, and accelerated resistance can result from harm done to helpful microorganisms.
Scientist Dr. Kamini Walia of ICMR underlined the need to change prescription practices: “We need to prioritize narrow-spectrum antibiotics, which target specific pathogens, rather than broadly prescribing antibiotics which fuel resistance.”
The need for antibiograms and rules based on microbiology to guide clinicians in selecting the most efficient antibiotic aggravates the problem. Many hospitals mandate that doctors write antibiotic prescriptions without enough knowledge of the germs causing the diseases.
Which local and worldwide initiatives aim to combat AMR?
Though these obstacles exist, there are indications of advancement. Novel antibiotics are being marketed by international collaborations akin to those between GARDP and Indian pharmaceutical firms. For moxifloxacin, an oral antibiotic to treat gonorrhea, which is becoming resistant to current treatments, GARDP is working with Aurigene Pharmaceutical Services in Hyderabad. With plans for manufacture in India, GARDP has also teamed with Shionogi, a pharma company based in Japan, to distribute cefiderocol—a breakthrough FDA-approved antibiotic for complicated infections like UTIs and hospital-acquired pneumonia—in 135 countries.
According to Dr. Walia, dealing with antibiotic resistance calls for a diverse strategy. “Effective water, sanitation, and hygiene will help to lower illnesses. Crucially essential elements of the answer are increasing vaccination rates, enhancing hospital infection control procedures, and teaching doctors.
The message is clear: we must fight antibiotic resistance immediately, and without concerted worldwide efforts, we run the danger of a future whereby even basic illnesses could become untreatable.
How Might the Rising AMR Crisis Be Solved?
Although new antibiotics are promising, the fight against superbugs is far from won. The speed at which germs change emphasizes the need for creativity, improved prescription guidelines, and more intense worldwide cooperation. Experts concur that without quick action, the world would see a future in which even minor infections could be fatal. “Improper and irresponsible use of antibiotics will compromise the lifetime of these new drugs,” Dr. Walia cautioned.
