Antibiotics have long been hailed as life-saving medicines. However, they now face a formidable enemy: bacteria that mutate, adapt, and resist the very drugs designed to combat them. These antibiotic-resistant “superbugs” caused 1.14 million deaths worldwide in 2021, as reported by The Lancet. In many cases, antibiotics failed to work.
India is particularly vulnerable to this crisis. In 2019, antibiotic-resistant infections caused approximately 300,000 deaths in the country. Among these, nearly 60,000 newborns died each year due to such infections.
Promising Indian Solutions to Superbugs
India is making strides with locally-developed drugs to fight antibiotic-resistant pathogens. These drugs aim to preserve last-resort treatments and offer hope.
Enmetazobactam: A Game-Changer from Chennai
Enmetazobactam, developed by Chennai-based Orchid Pharma, is the first Indian antimicrobial approved by the US Food and Drug Administration (FDA). This injectable drug treats severe infections like UTIs, pneumonia, and bloodstream infections. Instead of targeting bacteria directly, it neutralizes their defense mechanisms.
Bacteria often produce beta-lactamase enzymes to destroy antibiotics. Enmetazobactam binds tightly to these enzymes, disabling them and allowing antibiotics to work. By doing so, it prevents resistance and preserves the effectiveness of crucial drugs like carbapenems.
Clinical trials in 19 countries, involving over 1,000 patients, confirmed its efficacy. Dr. Maneesh Paul, one of the lead inventors, noted that it is only available in hospitals for critically ill patients and not sold over the counter.
Zaynich and Nafithromycin: Innovations from Wockhardt
Mumbai-based Wockhardt has developed Zaynich, an antibiotic for severe drug-resistant infections. It has been under development for 25 years and is in Phase-3 trials. Expected to launch next year, it has already saved 30 critically ill patients in compassionate-use cases.
Nafithromycin, also developed by Wockhardt and trademarked as MIQNAF, is a three-day oral treatment for bacterial pneumonia. With a 97% success rate, it addresses resistance rates as high as 60% in current treatments. Phase-3 trials are set to conclude soon, with a potential launch by late next year.
Global Collaboration and Future Challenges
Bengaluru-based Bugworks Research is working with the Geneva-based GARDP to develop a new class of antibiotics. Still in early Phase-1 trials, the drug may take five to eight years to reach the market. CEO Anand Anandkumar stressed the need for more innovation in antibiotic development, noting that big pharmaceutical companies focus on more profitable treatments like cancer and diabetes drugs.
GARDP is also collaborating with Indian and Japanese firms to produce breakthrough antibiotics like zoliflodacin for gonorrhea and cefiderocol for severe infections.
The Road Ahead
India’s fight against antimicrobial resistance requires more than new drugs. The Indian Council of Medical Research’s 2023 report highlights rising resistance in pathogens like E. coli and Klebsiella pneumoniae. Alarming trends include declining antibiotic effectiveness and growing resistance to carbapenems, a critical last-resort drug.
Experts stress the need for reform in prescription practices. Overuse of broad-spectrum antibiotics, often prescribed without proper guidelines, exacerbates resistance. Narrow-spectrum antibiotics and microbiology-based antibiograms should guide prescriptions.
Dr. Kamini Walia of ICMR warns against misuse of new drugs, emphasizing responsible use to preserve their effectiveness. Efforts must also focus on better sanitation, vaccination, hospital infection control, and education to reduce infections and prevent self-medication.
Without urgent action, the world risks a future where even minor infections become untreatable. Combating antimicrobial resistance demands innovation, accountability, and systemic reform.
