With the growing antibiotics administration, a parallel upsurge in antimicrobial resistance (AMR) is becoming a major threat to human development as it affects our ability to treat a range of infections caused by bacteria, parasites, viruses and fungi. Patients with resistant infections have to pay higher treatment costs in comparison to patients with non-resistant infection due to extended period of illness, the requirement for exclusive medicines and added tests. In order to tackle the additional burden coming from antimicrobial resistance, many pharmaceutical giants are developing stewardship strategies to monitor the use of antimicrobials in humans and animals, along with the antimicrobial load in the environment. Moreover, these strategies also emphasize on the development of new antimicrobial medicines to substitute those becoming less effective.

Finding the right balance between access and stewardship requires a concerted effort by multiple sectors (including farming and agriculture) and stakeholders (including governments and healthcare professionals). Pharmaceutical companies play a central role, due to their unique proficiency in transforming scientific innovations into capable candidates and arranging marketed products to millions of patients. As a result, it is key to maintain pharmaceutical companies engaged in the efforts to limit AMR. Unfortunately, market incentives to develop and deploy antimicrobials (and, in particular, antibiotics) are weak. Urgent requirement for new antibiotics is the main reason for failure to achieve the desired market is simple. Yet, tight control on the drugs once they reach the market shall limit the risk of emergence of resistance. Moreover, in comparison with other conventional drugs, antibiotics are cheaper and taken for a shorter time period. These factors, together with significant scientific and regulatory hurdles, make high-volume and/or high-margin pharmaceutical markets less likely to develop.

The global antibiotics market has been segmented based on drug class and route of administration. Among the considered drug classes, broad spectrum penicillins was the largest segment in 2018, contributing USD 10.96 billion. Broad-spectrum penicillins are invaluable in managing infectious diseases; yet, preventing their overuse is of utmost importance for avoiding infections that are being caused by multidrug-resistant organisms.

In low and middle income countries, broad spectrum antibiotics are randomly used for any condition by means of self-medication or from a chemist prescription. The pharmaceutical industry has a hold of widespread doctors and pharmacists exaggerating the efficiency of broad spectrum antibiotics and the message has filtered down to the end users. Medical practitioners are prescribing any available antibiotic for diseases such as typhoid, food poisoning and cholera. The perpetrator responsible in this situation is solely the authorities, which have failed to standardize regulations upholding the antibiotics market.

In India, fixed-dose combinations, of anti-amoebics like tinidazole and anti-bacterials like ciprofloxacin have become prevalent and are being used for all microbial diarrhoea. However, 90% of these diarrhoea cases are due to viruses and do not need medication. The remaining 9% cases are a result of bacterial or amoeba infection needing any anti-bacterial or an anti-amoebic, while the remaining 1% is due to a combination of bacteria and amoeba which requires a drug combination. Moreover, it turns out that only drug combinations are being used to treat all diarrhoea cases. These drug combinations are only marketed in India due to the negligent domestic regulations.

The global antibiotics market is cumulative to North America, Europe, Asia Pacific, Latin America and Middle East Africa. North America held the largest market share in 2018, however Asia Pacific is set to grow at a highest pace with a CAGR of 5.5%.

Countries like India and China are among the prominent antibiotic consumers in the Asian region. There is a country wide income rise in these nations leading to increased ability to purchase antibiotics, along with large population base. Moreover, lax regulations governing antibiotics is the prime driver for antibiotics market in these countries.

Furthermore, growing antibiotic consumption, is the main cause for the burden of antimicrobial resistance (AMR), where bacteria increasingly becomes resistant to the drugs. India, hence, dominates the AMR burden. The prescription rates of antibiotics is although, less in the country as compared to the other regions, however when it comes to third and fourth line antibiotics, India taps a many countries.