 "Reversing antibiotic resistance: Experts reveal what can still work")
Antibiotic resistance is no longer a distant threat. It is already reshaping the way doctors treat everything, from fevers to life-saving surgeries. Once-reliable drugs are failing, routine infections are becoming harder to cure, and even minor illnesses can escalate when antibiotics no longer work. Yet experts say all hope is not lost.
Antibiotic resistance can decline, older drugs can become effective again, and the most dangerous infections can be brought under control. But achieving this demands more than new medicines, it requires sustained behaviour change, sharper diagnostics, stronger surveillance, and coordinated action from hospitals, communities and policymakers alike.
Is reversing antibiotic resistance possible?
Clinicians say “reversal” means seeing fewer infections with high-level resistance, older antibiotics becoming effective again, and less need to use last-resort drugs. Reversing antibiotic resistance does not mean erasing the problem entirely. Most experts agree that a complete global reset is not possible.
“Reversing antibiotic resistance is realistic only under very limited and targeted conditions,” says Dr Tushar Tayal, Associate Director, Internal Medicine, CK Birla Hospital, Gurugram. When antibiotic use drops sharply and infection control improves, some bacteria lose their survival advantage and sensitive strains return.
Dr Bhanu Mishra, Consultant-Physician & Nephrologist, Fortis Hospital, adds, "True genetic reversion is rare. Instead, populations shift toward sensitivity once resistant strains lose their competitive advantages.”
What actually works in slowing antibiotic resistance?
According to experts, the strongest evidence points to antimicrobial stewardship, vaccination, infection control, and reduced unnecessary prescribing. Better sanitation and clean water also cut infections that trigger antibiotic use.
Breakthroughs in diagnostics could be a game-changer. Rapid molecular tests, point-of-care genomics, AI-guided detection tools and mass spectrometry help clinicians identify pathogens early and avoid broad-spectrum drugs.
Ophthalmology is adopting precision tools as well. Dr Shibu Varkey, Senior Cataract & Refractive Surgeon, Maxivision notes that PCR (polymerase chain reaction) testing detects corneal pathogens within hours, avoiding blind antibiotic use.
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Hospitals and communities must act together
Hospitals are hotspots for dangerous organisms and resistant bacteria. Infection-control measures such as hand hygiene, device care, sterilisation and isolation can reduce transmission within months.
However, community misuse remains a massive driver. “Most antibiotics in India are consumed outside hospitals,” warns Dr Maheshkumar Lakhe, Consultant in Infectious Diseases, Sahyadri Hospital, Pune. Over-the-counter access, self-medication and poor sanitation fuel resistance even before patients reach hospital care.
Highlighting the point Dr Varkey says, "Between 60–80 per cent of conjunctivitis cases are viral or allergic and do not need antibiotics, yet many people still use OTC eye drops." This kind of unnecessary and irregular use, he warns, fuels resistance.
Experts emphasise that hospital interventions stop the spread, while community measures prevent resistance from forming in the first place.
Better prescribing behaviour - key to slowing resistance
Improving how clinicians prescribe and how people use antibiotics can reshape resistance trends within a few years. Proper dosing, avoiding antibiotics for viral illnesses, and completing prescribed courses are essential. Public awareness is equally crucial.
"If clinicians follow appropriate prescribing practices and the public avoids over-the-counter antibiotic use while ensuring full completion of prescribed courses, we can expect meaningful improvements within two to three years," says Dr Kirti Sabnis, Infectious Diseases Specialist, Fortis Hospital, Mumbai.
When prescribers adhere to evidence-based guidelines and patients avoid pressures for antibiotics, resistance rates can decline, adds Dr Mishra.
Policy and funding gaps
Experts warn that policies exist but enforcement is weak. Funding for diagnostic scale-up and antibiotic R&D remains inadequate.
Surveillance is also a major blind spot, with the lack of real-time data, especially from rural areas, shares Dr Kuldeep Singh Sachdeva, President & Chief Medical Officer, Molbio Diagnostics.
Stronger international coordination, with sustained financial support, mandatory reporting, and equitable access to diagnostics, will be required for progress against resistance in the long term, adds Dr Mishra.
Progress with sustained action
Antibiotic resistance cannot be fully reversed, but it can be pushed back. With sustained stewardship, better diagnostics, regulated antibiotic sales and stronger national surveillance, experts say India could see measurable improvements within a few years.
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This report is for informational purposes only and is not a substitute for professional medical advice.