Antibiotics in India: When You Need Them and Why Self-Medication Is Dangerous

India is one of the world's largest consumers of antibiotics, and antimicrobial resistance (AMR) is a growing threat. Infections that were once easy to treat, such as typhoid and urinary infections, are increasingly hard to cure because bacteria have become resistant.

What antibiotics do and do not do

Antibiotics kill bacteria. They do nothing against viruses, which cause:

• The common cold
• Flu
• Most sore throats and coughs
• Dengue and chikungunya
• Most cases of loose motions in children

Taking an antibiotic for these will not make you better faster, but it can cause side effects and resistance.

Common antibiotics in India

These are prescription-only (Schedule H) medicines, sold legally only with a doctor's prescription.

Five rules for safe antibiotic use

1. Take antibiotics only when a doctor prescribes them. Do not use leftovers or medicines suggested by friends.
2. Complete the course exactly as prescribed, unless your doctor tells you to stop.
3. Never share antibiotics or use someone else's prescription.
4. Ask your doctor whether a test like a urine culture or blood culture is needed to pick the right antibiotic.
5. Tell your doctor about allergies, especially to penicillin.

Common side effects

• Diarrhoea, nausea and stomach upset
• Vaginal thrush in women
• Rashes

Seek urgent care for swelling of the face or lips, difficulty breathing, severe rash or bloody diarrhoea.

Fever: wait or treat?

Most fevers in India during monsoon are viral (including dengue). Doctors often recommend paracetamol, fluids and tests such as a CBC, dengue and malaria tests before deciding on antibiotics. A fever lasting more than 3 days, or with warning signs, needs a doctor.

The Red Line campaign

Look for the red vertical line on antibiotic packs. It signals a prescription-only antibiotic that should not be taken without a doctor's advice.

When to see a doctor

Consult a general physician or paediatrician before taking any antibiotic. On PlanMyDoc you can book a consultation and get a proper prescription.

What is antimicrobial resistance (AMR)?

Every time antibiotics are used, bacteria that can survive them have a chance to multiply. Over time, these resistant bacteria spread between people, in hospitals and through water and food. Indian surveillance by ICMR has documented rising resistance in common bacteria such as E. coli, Klebsiella and Salmonella Typhi. When first-line antibiotics fail, patients need stronger, costlier and sometimes injectable drugs.

Antibiotics and children

Most childhood fevers, colds, coughs and diarrhoea are viral. For children with loose motions, ORS and zinc, not antibiotics, are usually the right treatment. Give children antibiotics only when prescribed, at the weight-based dose your paediatrician sets, using the measuring device in the pack.

Can antibiotics be taken with food or milk?

It depends on the medicine. For example, doxycycline and ciprofloxacin should be kept apart from milk, antacids, calcium and iron, while amoxicillin-clavulanate is best taken at the start of a meal. Follow the label or ask your pharmacist.

Antibiotics and alcohol

Alcohol is best avoided during most infections. With metronidazole, alcohol can cause a severe reaction with vomiting and palpitations, so avoid it during the course and for 48 hours after.

Protecting your gut

Antibiotics can upset the natural bacteria in your gut, causing diarrhoea. Some doctors suggest probiotics or curd. Seek medical care if diarrhoea is severe, bloody or continues after the course ends.

Dispose of leftover antibiotics safely

Do not keep leftover antibiotics "for next time". Ask your pharmacist how to dispose of them, and never flush them or throw them loose in the bin.

Myths and facts

• Myth: "A stronger antibiotic works faster." Fact: The right antibiotic for the specific infection works best.
• Myth: "Yellow or green phlegm means I need antibiotics." Fact: Coloured phlegm is common in viral infections too.