Antibiotic prescribing and resistance beyond hospital surveillance networks in India
- 1IIIT-Delhi
Abstract
Hospital-based surveillance captures important components of antimicrobial resistance in India, but community-facing data linking prescribing and resistance remain limited. To address this, we analysed routinely generated prescription and diagnostic data from Tata 1mg from 2023 to 2025. Among 25.7 million medicines prescribed, 10.8% were antibiotics, with Watch antibiotics exceeding Access antibiotics in every state meeting the inclusion criteria. Among 156,000 diagnostic microbiology samples, urine cultures predominated, with Escherichia coli accounting for 60.6% of culture-positive isolates. In urinary E. coli, resistance was low to the Access antibiotics nitrofurantoin and amikacin (4.9% each), but high to the Watch antibiotics ceftriaxone (53.6%) and ciprofloxacin (57.0%). Exploratory cross-correlation analyses identified lead-lag relationships in which resistance to selected Watch antibiotics preceded changes in resistance to Access antibiotics by approximately 3-6 months. Routine digital healthcare data can therefore support community-facing AMR surveillance by jointly characterising platform-recorded prescribing and susceptibility within the observed care pathway.
Related
- Appropriateness of antibiotic prescribing in dental practice: results of two clinical audits conducted at a university hospital
- Antibiotic resistance patterns and associated genetic determinants among clinical isolates of Pseudomonas aeruginosa from a tertiary hospital in southern Iraq
- The Negative Externalities of Lying and of Inappropriate Antibiotic Prescribing
- Review of antibiotic prescribing in fluoroscopic procedures and indwelling tubes in paediatric urology
- The Knowledge‐Practice Gap in Prescribing: A Study of Perceptual and Experiential Predictors at Asella Referral and Teaching Hospital, Ethiopia—A Cross‐Sectional Study
BibTeX
@misc{kaur2026antibiotic,
title = {{Antibiotic prescribing and resistance beyond hospital surveillance networks in India}},
author = {J. Kaur and V. Madaan and R. Sharma and Z. Agarwal and N. Gudi and T. Bisen and S. Gupte and A. Mutreja and N. Doegar and H. Singh and G. Agarwal and T. Sethi},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.08.26365044},
url = {https://www.medrxiv.org/content/10.64898/2026.10.08.26365044v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Antibiotic prescribing and resistance beyond hospital surveillance networks in India
AU - J. Kaur
AU - V. Madaan
AU - R. Sharma
AU - Z. Agarwal
AU - N. Gudi
AU - T. Bisen
AU - S. Gupte
AU - A. Mutreja
AU - N. Doegar
AU - H. Singh
AU - G. Agarwal
AU - T. Sethi
PY - 2026
DA - 2026/10/08
PB - medRxiv
DO - 10.64898/2026.10.08.26365044
UR - https://www.medrxiv.org/content/10.64898/2026.10.08.26365044v1
AB - Hospital-based surveillance captures important components of antimicrobial resistance in India, but community-facing data linking prescribing and resistance remain limited. To address this, we analysed routinely generated prescription and diagnostic data from Tata 1mg from 2023 to 2025. Among 25.7 million medicines prescribed, 10.8% were antibiotics, with Watch antibiotics exceeding Access antibiotics in every state meeting the inclusion criteria. Among 156,000 diagnostic microbiology samples, urine cultures predominated, with Escherichia coli accounting for 60.6% of culture-positive isolates. In urinary E. coli, resistance was low to the Access antibiotics nitrofurantoin and amikacin (4.9% each), but high to the Watch antibiotics ceftriaxone (53.6%) and ciprofloxacin (57.0%). Exploratory cross-correlation analyses identified lead-lag relationships in which resistance to selected Watch antibiotics preceded changes in resistance to Access antibiotics by approximately 3-6 months. Routine digital healthcare data can therefore support community-facing AMR surveillance by jointly characterising platform-recorded prescribing and susceptibility within the observed care pathway.
ER -