ArticleBulletin of the World Health Organization2022
Systemic antibiotic sales and WHO recommendations, India.
Article in Bulletin of the World Health Organization, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Reframing Antimicrobial Stewardship as Systems Governance: Aligning Regulation, Diagnostics, Antibiotic Use Measurement, and Surveillance to Address Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2026Review
- Assessment of antimicrobial use among patients admitted to a tertiary care hospital: A prospective observational study using World Health Organization AWaRe and Indian Council of Medical Research guidelines.Indian journal of pharmacology · 2026Observational
- Did the periodic intensification of routine immunisation strategy (Intensified mission Indradhanush) reduce the demand for pediatric antibiotic formulations in India?BMC infectious diseases · 2025Article
- Increasing the use of the WHO AWaRe system in antibiotic surveillance and stewardship programmes in low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- To assess the availability of antibiotics for online sale and comparison of e-pharmacies on key characteristics influencing safe and rational use of antibiotics: an exploratory analysis.JAC-antimicrobial resistance · 2024Article
- Regulatory enforcement of the marketing of fixed-dose combinations in India: a case study of systemic antibiotics.Journal of pharmaceutical policy and practice · 2023Article
- Not recommended fixed-dose antibiotic combinations in low- and middle-income countries - the example of Tanzania.Antimicrobial resistance and infection control · 2023Review
- Systemic antibiotic sales and WHO recommendations, India.Bulletin of the World Health Organization · 2022Article
- Rising antimicrobial resistance: Impending post-antibiotic era?Medical journal, Armed Forces IndiaArticle
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To analyse sales of fixed-dose combination and single antibiotics in India in relation to World Health Organization (WHO) recommendations and national regulatory efforts to control antibiotic sales. Methods: We extracted data on sales volumes of systemic antibiotics in India from a market research company sales database. We compared the market share of antibiotic sales in 2020 by WHO AWaRe (Access, Watch and Reserve) category and for those under additional national regulatory controls. We also analysed sales of fixed-dose combinations that were: formally approved for marketing or had a no-objection certificate; on the national essential medicines list; and on the WHO list of not-recommended antibiotics. Findings: There were 78 single and 112 fixed-dose combination antibiotics marketed in India, accounting for 7.6 and 4.5 billion standard units of total sales, respectively. Access, Watch and Reserve antibiotics comprised 5.8, 5.6 and 0.1 billion standard units of total market sales, respectively. All additionally controlled antibiotics were Watch and Reserve antibiotics (23.6%; 2.9 billion standard units of total sales). Fixed-dose combinations on the WHO not-recommended list were marketed in 229 formulations, with 114 formulations (49.8%) having no record of formal approval or no-objection certificate. While there were no not-recommended fixed-dose combinations on the national list of essential medicines, 13 of the top-20 selling antibiotic fixed-dose combinations were WHO not-recommended. Conclusion: The sale of Watch group drugs, and antibiotics banned or not approved, needs active investigation and enforcement in India. The evidence base underpinning formal approvals and no-objection certificates for not-recommended fixed-dose combinations should be audited.
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