Antibiotics are life-saving drugs but face a growing challenge from bacteria that adapt and resist their effects. These antibiotic-resistant “superbugs” caused 1.14 million deaths globally in 2021, according to The Lancet. Antibiotics, typically the first defense against severe infections, failed in most of these cases.
India is among the hardest-hit nations. In 2019, antibiotic-resistant infections caused about 300,000 deaths in the country, including nearly 60,000 newborn deaths annually.
However, hope is emerging in the form of innovative, locally-developed drugs to tackle these pathogens and preserve critical treatments.
India’s Promising New Antibiotics
Enmetazobactam: A Game-Changer
Chennai-based Orchid Pharma developed Enmetazobactam, the first Indian antimicrobial approved by the US FDA. This injectable drug treats serious infections, such as urinary tract infections (UTIs), pneumonia, and bloodstream infections. It works by targeting bacterial defense mechanisms, neutralizing enzymes like beta-lactamase, and allowing antibiotics to kill bacteria effectively.
“The drug disables bacteria’s defenses without triggering resistance easily,” explained Dr. Maneesh Paul, its lead co-inventor. Administered intravenously in hospitals for critical patients, it is not available over the counter. Trials in 19 countries with over 1,000 patients showed its effectiveness and safety.
Wockhardt’s Revolutionary Drugs
Mumbai-based Wockhardt is testing two new antibiotics, Zaynich and Nafithromycin.
- Zaynich: After 25 years of development, this drug is in Phase-3 trials and may launch next year. It was given compassionately to 30 critically ill patients in India who were unresponsive to other antibiotics. Remarkably, all survived.
- Nafithromycin (MIQNAF): A three-day oral treatment for bacterial pneumonia, it achieved a 97% success rate in trials. Wockhardt plans to release it commercially by late next year if approved.
Bugworks Research and Global Collaboration
Bengaluru-based Bugworks Research is developing a new antibiotic class in partnership with GARDP. The drug is in early Phase-1 trials and could take 5-8 years to hit the market.
Despite limited funding, CEO Anand Anandkumar is determined to address antibiotic resistance. “Big pharma prioritizes cancer and diabetes drugs over antibiotics,” he said. Less than 10% of Bugworks’ funding comes from India.
A Tough Battle Against Resistance
Antibiotic resistance in India is rising at an alarming rate. A 2023 Indian Council of Medical Research (ICMR) report analyzed over 100,000 bacterial cultures and found declining antibiotic effectiveness against common pathogens like E. coli and Klebsiella pneumoniae. Some antibiotics were less than 15% effective against these infections. Resistance to last-resort drugs like carbapenems is especially concerning.
Dr. Manica Balasegaram, GARDP’s executive director, emphasized the need for innovation. “Bacteria evolve rapidly, and we’re always catching up,” he said.
GARDP is also working with Indian and global partners to produce new antibiotics like Zoliflodacin for gonorrhea and distribute cefiderocol, a breakthrough drug for tough infections, in over 135 countries.
Reforming Drug Practices
Experts stress the need to reform antibiotic prescription practices in India. Broad-spectrum antibiotics, though widely used, promote resistance and should be replaced with narrow-spectrum drugs. Many hospitals lack antibiograms—guidelines based on microbiological data—which forces doctors to prescribe broadly.
Dr. Kamini Walia from ICMR warned against misusing new drugs. “Improper use will compromise their longevity,” she said.
A holistic approach is crucial to address this crisis. It includes improving sanitation, boosting vaccination, strengthening infection control in hospitals, and educating both doctors and patients.
Without urgent action, the world risks a future where minor infections become untreatable. Combating antimicrobial resistance demands a multi-faceted, systemic response.