New Superbugs Are Winning—Here’s Why
Health experts are sounding the alarm over the increasing misuse of a powerful antibiotic, ceftazidime-avibactam, which is crucial in treating life-threatening infections. Dr. Abdul Ghafur, an infectious diseases specialist and founder of the AMR Declaration Trust, has formally appealed to Rajeev Singh Raghuvanshi, the Drugs Controller General of India (DCGI), highlighting the urgent need for strict regulations on the use of this medicine.
According to Dr. Ghafur, this life-saving antibiotic is already losing its effectiveness due to uncontrolled and irrational use in the community. “Ceftazidime-avibactam is among the strongest antibiotics we currently have. But if its misuse continues, it may no longer be effective against resistant infections,” he cautioned.
What Is Ceftazidime-Avibactam and Why It Matters
Initially approved by the U.S. FDA in 2015 and later in India in 2018, ceftazidime-avibactam is classified as a last-resort antibiotic. It is intended to treat specific infections caused by carbapenem-resistant gram-negative bacteria. It should be used only when no other antibiotics are effective—not as a general-purpose antibiotic.
Despite its specific role, the drug is being used widely and inappropriately, which experts fear will accelerate resistance. To tackle difficult infections, doctors sometimes combine it with another drug, aztreonam. However, resistance has now begun to emerge even against this combination, mainly due to its excessive and improper use.
Lack of Clear Guidelines: A Serious Gap
Although the DCGI has approved the drug for use, Dr. Ghafur points out that the guidelines provided only suggest its indications without defining clear rules or restrictions. As a result, there is nothing in place to prevent healthcare providers from prescribing it incorrectly.
This lack of regulation could reverse the recent success India achieved with antibiotic control—especially the significant reduction in colistin-resistant bacteria after the government banned colistin as a growth enhancer in poultry. Dr. Ghafur called this move a “bold and meaningful action” that showed how regulation can improve public health outcomes.
New Antibiotics on the Horizon: A Need for Caution
India is soon expected to introduce two new antibiotics: cefiderocol and cefepime-zidebactam. While these drugs offer hope in combating drug-resistant infections, Dr. Ghafur emphasizes that their use must be tightly controlled.
“We do need these drugs. But they should be reserved strictly for infections where no other treatments work,” he said. “Education alone won’t be enough, we must have a well-defined regulatory framework from the moment these drugs are launched.”
The Bigger Picture: Antimicrobial Resistance (AMR)
Antimicrobial resistance is already a serious public health threat in India. Without timely and decisive action, it could grow into an uncontrollable crisis. “We cannot undo past misuse,” Dr. Ghafur warned, “but we still have a window of opportunity to act responsibly for the future.”
Conclusion
Experts urge the government and regulatory authorities to implement strict guidelines for the use of potent antibiotics, including those already in use and those about to be introduced. Rational prescribing, backed by clear policies, is the need of the hour to safeguard the effectiveness of these critical drugs for future generations.
Source: Inputs from various media Sources
Priya Bairagi
Reviewed by Dr Aarti Nehra (MBBS, MMST)
I’m a pharmacist with a strong background in health sciences. I hold a BSc from Delhi University and a pharmacy degree from PDM University. I write articles and daily health news while interviewing doctors to bring you the latest insights. In my free time, you’ll find me at the gym or lost in a sci-fi novel.
