Antibiotic prescribing and resistance beyond hospital surveillance networks in India

Hospital-based surveillance captures important components of antimicrobial resistance in India, but community-facing data linking prescribing and resistance remain limited. To address this, we analysed routinely generated prescription and diagnostic data from Tata 1mg from 2023 to 2025. Among 25.7 million medicines prescribed, 10.8% were antibiotics, with Watch antibiotics exceeding Access antibiotics in every state meeting the inclusion criteria. Among 156,000 diagnostic microbiology samples, urine cultures predominated, with Escherichia coli accounting for 60.6% of culture-positive isolates.

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