Raids conducted across 193 locations in multiple districts uncovered pharmacies brazenly selling antibiotics without proper prescriptions, operating without registered pharmacists, and failing to maintain mandatory drug registers.

Published Jun 15, 2025 | 8:00 AM ⚊ Updated Jun 15, 2025 | 8:00 AM



As threat of antimicrobial resistance grows, Telangana joins Kerala in crackdown on antibiotic misuse

Synopsis: In response to the growing threat of antimicrobial resistance, now considered one of the top global health threats by the World Health Organization, Telangana on Thursday launched a sweeping crackdown on the illegal sale of antibiotics, uncovering widespread violations such as sales without prescriptions, a lack of qualified pharmacists, and failure to maintain mandatory drug registers.

The Telangana Drug Control Administration (DCA) launched a comprehensive state-wide crackdown on the indiscriminate sale of antibiotics on Thursday, 12 June.

The operation, aimed at curbing antimicrobial resistance (AMR) – which the World Health Organization has declared as one of the top ten global public health threats facing humanity – has revealed alarming violations.

Raids conducted across 193 medical establishments in multiple districts uncovered medical shops brazenly selling antibiotics without proper prescriptions, operating without registered pharmacists, and failing to maintain mandatory drug registers.

The action follows the Kerala government’s recent suspension of 450 pharmacy licences and the cancellation of five more in a crackdown on the misuse of antibiotics. The move is part of the state’s Antimicrobial Resistance Strategic Action Plan.

The Health Department in Kerala has introduced stricter rules on prescriptions and has already reduced unnecessary antibiotic use by up to 30 percent.

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Widespread regulatory non-compliance

The investigation uncovered multiple layers of non-compliance that paint a troubling picture of antibiotic governance in the state.

“Medical establishments were found selling antibiotics without prescriptions from quacks, issuing medicines without proper sale bills, and operating in the absence of qualified pharmacists. Perhaps most concerning was the widespread failure to maintain Schedule H1 Drug Registers and Prescription Registers specifically for antibiotics – critical documentation systems designed to track and monitor antibiotic distribution,” said the DCA in a statement.

“Antimicrobial resistance or AMR is a global health care crisis,” said Shahnawaz Qasim, Director General of the Drug Control Administration.

“The WHO has declared that AMR is one of the top ten global public health threats facing humanity. It is estimated by WHO that bacterial antimicrobial resistance was directly responsible for 12.7 lakh global deaths in 2019.”

The statistics are particularly sobering for India, which reports among the highest rates of antimicrobial resistance worldwide.

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What antimicrobial resistance means for public health

Antimicrobial resistance represents a complex challenge that extends far beyond simple medication misuse.

The phenomenon encompasses resistance to antibiotics, antivirals, antifungals, and antiparasitics, with bacterial antibiotic resistance showing the most alarming global increase.

When bacteria develop the ability to withstand antibiotic effects, common infections become increasingly difficult or impossible to treat, leading to the emergence of dangerous “superbugs”.

“When used incorrectly, bacteria start to acquire resistance to the antibiotics designed to kill them,” Qasim explained.

“As a result of drug resistance, antibiotics become ineffective and infections become difficult or impossible to treat. When bacteria become resistant, they develop into superbugs which can spread from person to person.”

The development of antimicrobial resistance, while a natural evolutionary phenomenon, has been dramatically accelerated by human actions.

Over-prescribing by healthcare providers, inappropriate use in agriculture and livestock, and the unregulated over-the-counter sale of antibiotics have created a perfect storm for resistance development.

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Existing laws and the path to stronger enforcement

The legal foundation for the current crackdown rests on the Drugs and Cosmetics Act of 1940 and associated rules, which classify antibiotics as prescription drugs under Schedule H and Schedule H1 classifications.

These regulations explicitly prohibit the sale of antibiotics without proper medical prescriptions, making the violations discovered during the raids punishable offences.

“Antibiotics are prescription drugs,” Qasim emphasised.

“Antibiotics cannot be sold by medical shops or pharmacies without the prescription of a qualified doctor. Over-the-counter sale of antibiotics to patients by medical shops and pharmacies is punishable under the Drugs and Cosmetics Act.”

The 193 show cause notices issued represent the first step in a systematic enforcement process that could result in significant penalties for violating establishments.

The DCA has indicated that appropriate action will be taken in accordance with existing legal provisions, signalling a zero-tolerance approach to antibiotic misuse.

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Addressing AMR requires action across sectors

DCA also said that the fight against AMR requires coordination across multiple sectors and stakeholders. Healthcare providers must implement rigorous infection prevention and control measures while ensuring antibiotics are prescribed only when necessary and appropriate.

The agricultural sector faces pressure to eliminate the use of antibiotics for growth promotion in livestock, poultry, and fish farming.

Environmental factors also play a crucial role, with pollution from pharmaceutical manufacturing units and inappropriate disposal of unused antibiotics contributing to resistance development.

“Preventing antimicrobial resistance is a complex task and requires a multifaceted approach involving doctors and other health care professionals, regulatory authorities, industries and general public,” Qasim noted.

Beyond enforcement, the DCA has launched an extensive public education campaign emphasising individual responsibility in combating antimicrobial resistance.

“The public has a crucial role in combating antimicrobial resistance,” Qasim stated.

“Antibiotics should be used only when prescribed by a qualified doctor. Antimicrobial resistance can occur when you take an antibiotic that you do not need. Misuse and overuse of antibiotics is harmful.”

The educational component emphasises that antibiotics are effective only against bacterial infections, not viral conditions, and stresses the importance of completing full treatment courses even when symptoms improve.

The campaign also discourages sharing antibiotics or using leftover medications from previous treatments.

“Be medicine smart!” Qasim urged the public.

“Before you use antibiotics or buy them from medical shops, stop and think: If I take this without a prescription, will it stop working for me when I need it? Please remember: When you take antibiotics even if you don’t need them, they can stop working when you need them most.”

(Edited by Dese Gowda)