ArticleAntibiotics (Basel, Switzerland)2022
Marketing and Distribution System Foster Misuse of Antibiotics in the Community: Insights from Drugs Wholesalers in India.
Article in Antibiotics (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Antimicrobial prescription pattern and appropriateness for respiratory tract infection in outpatients: a systematic review and meta-analysis.Systematic reviews · 2024Pooled it
- Antimicrobial peptides as sustainable alternatives to antibiotics in livestock production: implications for animal health in tropical and sub-tropical systems.Tropical animal health and production · 2026Review
- Reframing Antimicrobial Stewardship as Systems Governance: Aligning Regulation, Diagnostics, Antibiotic Use Measurement, and Surveillance to Address Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2026Review
- Primary caregivers' practices and perceptions on antibiotic use and resistance: a one health qualitative study in rural South India.BMJ open · 2026Article
- Rule-Breaking and Rulemaking: Governance of the Antibiotic Value Chain in Rural and Peri-Urban India.Antibiotics (Basel, Switzerland) · 2025Article
- Comprehensive Molecular Profiling of AcrAB-TolC Efflux Pump Genes in Salmonella typhi Isolates from Typhoid Infected Patients.Current microbiology · 2025Article
- Article
- RETRACTED: Empowering Low- and Middle-Income Countries to Combat AMR by Minimal Use of Antibiotics: A Way Forward.Antibiotics (Basel, Switzerland) · 2023Article
- Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Antibiotic misuse is one of the major drivers of antimicrobial resistance (AMR). In India, evidence of antibiotic misuse comes largely from retailers as well as formal and informal healthcare providers (IHCPs). This paper presents the practices and perspectives of drug wholesalers, a critical link between manufacturers and last-mile dispensers. Four experienced wholesalers and an ex-State Drug Controller (ex-SDC) were interviewed in depth, using semi-structured guides in the National Capital Region of Delhi, India, between November 2020 and January 2021. Four main findings were that wholesalers (i) have limited knowledge about wholesale licensing and practice regulations, as well as a limited understanding of AMR; (ii) directly supply and sell antibiotics to IHCPs; (iii) facilitate medical representatives (MRs) of pharmaceutical companies and manufacturers in their strategies to promote antibiotics use in the community; and (iv) blame other stakeholders for unlawful sale and overuse of antibiotics. Some of the potential solutions aimed at wholesalers include having a minimum education qualification for licensing and mandatory Good Distribution Practices certification programs. Decoupling incentives by pharmaceutical companies from sales targets to improve ethical sales practices for MRs and optimize antibiotic use by IHCPs could alleviate wholesalers' indirect actions in promoting antibiotic misuse.
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Registered trials
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