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India generates more antibiotic prescribing data than almost any country on earth. Very little of it is captured in a form that can improve the next prescription, said Ashissh Raichura, founder & CEO, Scanbo Technologies.
Prescriptions written on paper, sold without records, and rarely tied back to outcomes leave the system blind to what is actually happening in the field. Anti-microbial resistance (AMR) surveillance depends on knowing what is being prescribed, to whom, with what result, and how resistance is evolving locally, he added.
Today, most of that information is either invisible or arrives too late to be useful. This is not primarily a technology problem. It is a data-infrastructure and governance problem. Structured capture at the point of prescribing, connected to laboratory outcomes and local resistance data, is what would turn AMR from a slow-moving crisis into a manageable one. Until the data foundation exists, every drug policy sits on top of a system that cannot measure whether it is working, Raichura told Pharmabiz.
The antibiotic paradox on overuse and undertreating with the same drugs is real, and it exists at the point-of-care. In urban India, antibiotics are often prescribed for viral infections despite the absence of clinical indications, owing to patient expectations, clinician time pressure, and the unavailability of confirmatory diagnostic tests at the time of clinical decision-making. In rural India, patients with genuine bacterial infections often go untreated because they never reach a clinician, or they self-medicate incompletely. The same drug exhibits opposite failure modes, both driven by the absence of reliable diagnostic support at the point of care. Without rapid confirmation of whether an infection is bacterial or viral, clinicians are often compelled to rely on empirical antibiotic prescribing. India will not solve one side of the paradox without addressing the other, and both roads run through better point-of-care diagnostics and better clinical decision support, noted Raichura.
A substantial diagnostic gap underlies AMR. While antimicrobial resistance is commonly viewed as a prescribing problem, it is fundamentally a diagnostic problem that translates into inappropriate prescribing. In the absence of timely and reliable diagnostic information, clinicians frequently rely on empirical antibiotic therapy, increasing the risk of unnecessary antibiotic use and accelerating the development of drug resistance.
India’s frontline is where this gap is widest. Culture and sensitivity testing takes days, is unavailable in most primary care settings, and rarely informs the first prescription. Meanwhile, resistance profiles evolve locally and are almost never captured in a form that helps the clinician tomorrow. Closing this gap requires two shifts. One is making rapid diagnostic capability available where prescribing decisions actually happen. The other is building clinical decision support that draws on local resistance patterns instead of textbooks alone. Without those two shifts, the country will continue to escalate to stronger antibiotics faster than resistance can be contained, said Raichura.
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