Antibiotics, once hailed as life-saving drugs, now face a formidable challenge: bacteria that mutate, adapt, and resist treatment. These antibiotic-resistant “superbugs” caused 1.14 million deaths worldwide in 2021, according to The Lancet. Despite being the first line of defense against severe infections, antibiotics failed in most of these cases.
India is among the worst-affected nations by antimicrobial resistance (AMR). In 2019 alone, antibiotic-resistant infections claimed 300,000 lives, including nearly 60,000 newborns annually. However, hope lies in several promising drugs developed locally to tackle resistant pathogens and protect last-resort treatments.
Revolutionary Drugs Developed in India
Enmetazobactam
Chennai-based Orchid Pharma developed Enmetazobactam, India’s first antimicrobial approved by the US Food and Drug Administration (FDA). This injectable drug treats severe conditions like urinary tract infections (UTIs), pneumonia, and bloodstream infections by targeting bacterial defense mechanisms rather than the bacteria itself.
Enmetazobactam neutralizes enzymes like beta-lactamase, allowing antibiotics to work effectively. It also helps preserve other critical antibiotics, including carbapenems. Tested on over 1,000 patients across 19 countries, this IV-administered drug showed significant potency. Dr. Maneesh Paul, a lead co-inventor, explained its importance for critically ill patients in hospitals.
Zaynich and Nafithromycin
Mumbai-based Wockhardt is developing Zaynich, a new antibiotic designed to combat all major superbugs. After 25 years of research, it is in Phase-3 trials and expected to launch next year. Used compassionately on 30 critically ill Indian patients unresponsive to other antibiotics, all survived.
Wockhardt is also testing Nafithromycin, branded as MIQNAF, a three-day oral treatment for bacterial pneumonia with a 97% success rate. It could launch commercially by late next year, addressing diseases where existing treatments face up to 60% resistance.
Other Innovations
Bengaluru-based Bugworks Research is collaborating with the Global Antibiotic Research and Development Partnership (GARDP) to develop a new antibiotic class targeting resistant infections. Currently in Phase-1 trials, this innovation could be market-ready in 5–8 years. Meanwhile, GARDP partners with Hyderabad’s Aurigene to produce zoliflodacin, a novel antibiotic for gonorrhea, and works with Japan’s Shionogi to distribute cefiderocol for tough infections.
The Broader Battle Against Resistance
India faces a rising threat from bacteria like E. coli, Klebsiella pneumoniae, and Acinetobacter baumannii. A 2023 Indian Council of Medical Research (ICMR) report found significant declines in antibiotic effectiveness. Some key antibiotics were less than 15% effective against these pathogens.
Dr. Manica Balasegaram of GARDP compares fighting bacteria to “playing whack-a-mole.” Their rapid evolution demands constant innovation. While GARDP focuses heavily on India, systemic challenges remain.
Prescription Practices Need Reform
Excessive use of broad-spectrum antibiotics fuels resistance. Doctors often prescribe them due to a lack of antibiograms, which guide narrow-spectrum antibiotic use. Scientists like Dr. Kamini Walia warn against repeating past mistakes with new drugs. Misuse could compromise their longevity.
A Holistic Approach
Reducing infections through better hygiene, sanitation, and vaccination is critical. Improved hospital infection controls, physician education, and discouraging self-medication are equally vital.
“Combating AMR is a complex, multi-faceted challenge tied to healthcare equity and accountability,” says Dr. Walia. Without urgent action, even minor infections could become untreatable, threatening a return to a pre-antibiotic era.