The future of fighting AMR in India

This article is authored by Saransh Chaudhary, president, Global Critical Care, Venus Remedies Ltd and CEO, Venus Medicine Research Centre.

Picture the future; Rahul, a 32-year-old marketing professional in Bangalore, wakes up in 2030 with a familiar discomfort: Burning urination. Instead of heading to a pharmacy for a quick antibiotic fix, he reaches for a ₹150 home infection test kit. Within 15 minutes, the result is clear: E. coli detected, along with guidance on which antibiotics are likely to be effective. Armed with this information, Rahul books an online consultation. His doctor reviews the results, confirms the pathogen and its resistance pattern, and prescribes the most appropriate antibiotic in the right dose.

AMR (Representational Image)

This is what the next chapter in the fight against antimicrobial resistance (AMR) could look like — one where treatment decisions are driven by evidence, not guesswork, and antibiotics are used only when they are truly needed.

Today, the same Rahul would likely walk into a pharmacy, describe his symptoms, and leave with ciprofloxacin — contributing, unknowingly, to India’s worsening fluoroquinolone resistance crisis. Self-medication remains common, and over-prescription is routine.

A 2023 ICMR study found that more than 60% of people discuss antibiotic use with doctors only during follow-up visits, and 40% are unaware of the risks of stopping treatment prematurely. Even more concerning, 20% of Indian children receive antibiotics without a prescription, according to research published in BMC Pediatrics.

The result is predictable. Casual misuse is fueling widespread resistance. Data from the Gujarat Biotechnology Research Centre shows that salmonella typhi, the bacteria responsible for typhoid, is now resistant to up to 90% of commonly used antibiotics. Similar trends are seen across a range of infections. For urinary tract infections, 44% of patients receive antibiotics before any diagnostic testing, according to ICMR’s 2023 UTI surveillance report. Without laboratory confirmation, inappropriate prescriptions go unchecked and resistance accelerates.

The good news is that innovation is catching up. Researchers at King George’s Medical University have developed molecular tests that identify bacteria and resistance patterns within six hours — a dramatic improvement over the 72 hours required for conventional culture. At IIT-Madras, scientists have created a lab-on-chip device that can detect resistance in just three hours, a breakthrough that could make rapid testing accessible even in rural clinics.

ICMR has also issued protocols for point-of-care (PoC) susceptibility testing, strengthening diagnostic capacity at smaller hospitals. The market is evolving in parallel: India’s point-of-care diagnostics sector, valued at $ 628 million in 2024, is projected to cross $ 1 billion by 2030, with AMR-focused diagnostics expected to reach $ 283 million.

Diagnostics are not just tools for detection — they are catalysts for behavioral change. India’s experience with over a billion at-home Covid-19 tests showed that self-testing can scale quickly and affordably. The same principle can extend to bacterial infections, where early testing can shift patient habits from “treat first” to “test first.”

A positive bacterial test prompts timely medical consultation, while a negative result can prevent unnecessary prescriptions altogether. This creates a virtuous cycle: testing leads to better treatment choices, which leads to improved outcomes and less resistance pressure. Over time, pre-treatment testing can become a routine part of health care, reinforcing stewardship and improving both individual and public health.

Diagnostics, however, are not substitutes for medical judgment. Prescriptions must still account for patient-specific factors such as allergies, comorbidities, pregnancy, and organ function. The guiding principle remains clear: diagnostics inform decisions, but doctors make them.

Yet for rapid testing to truly transform antibiotic use, the technology itself must evolve. Detecting a single pathogen like E. coli is valuable, but its real public health impact will remain limited unless diagnostic tools can identify a broader range of bacteria and resistance mechanisms commonly associated with infections. Expanding the spectrum of detection — from staphylococcus aureus in skin infections to klebsiella pneumoniae and pseudomonas aeruginosa in hospital-acquired infections — is essential to make pre-prescription testing relevant for most clinical scenarios. Without this breadth, adoption will remain confined to niche use cases, and large-scale behavior change will be harder to achieve.

To enable this shift, regulatory support and infrastructure will be crucial. CDSCO approvals must go hand in hand with guidelines that promote comprehensive diagnostic development and require medical consultation before antibiotic use. Public-private partnerships can help accelerate innovation and scale distribution through pharmacies and e-commerce platforms. Equally important, nationwide awareness campaigns can educate people on the role of diagnostics in distinguishing bacterial from viral infections — reinforcing testing as a first step, not an afterthought, in effective antibiotic stewardship.

India’s fight against AMR will increasingly depend on empowered consumers. Whether it’s Rahul in an urban apartment or a farmer in rural Maharashtra, access to affordable diagnostic kits and telemedicine services can transform how infections are managed.

The technology already exists. The task now is to scale it, normalise pre-treatment testing, and integrate it into care pathways. Each diagnostic decision becomes an act of stewardship — a small, individual choice with large public health consequences.

Antimicrobial resistance is not only a medical crisis but also a behavioral one. With the right mix of technology, regulation, and awareness, India can show how diagnostics, not just new drugs, can turn the tide in one of the most urgent health challenges of our time.

This article is authored by Saransh Chaudhary, president, Global Critical Care, Venus Remedies Ltd and CEO, Venus Medicine Research Centre.