ANTIBIOTIC MISUSE AND ANTIMICROBIAL RESISTANCE IN INDIA: A PHARMACEUTICS PERSPECTIVE ON FORMULATION DESIGN, PACKAGING, AND PATIENT ADHERENCE

Antimicrobial resistance (AMR) has surfaced as a significant worldwide public health challenge predominantly fueled by improper antibiotic usage. Although current research mainly links antibiotic misuse to behavioural issues like inadequate adherence and illogical prescribing, the role of pharmaceutics—such as formulation design, dosage intricacy, and packaging—has yet to be sufficiently examined. This analysis explores the misuse of antibiotics from a pharmaceutical standpoint and emphasizes how drug formulation and administration methods affect patient behaviour, adherence to treatment, and the emergence of resistance. In India, extensive use of antibiotics, easy access without prescriptions, and poor regulatory enforcement greatly lead to misuse. Insufficient drug exposure from missed doses, early termination, and unsuitable formulations exerts selective pressure that encourages resistant microorganisms. This review additionally explores the impact of dosage form complexity, packaging systems, modified-release formulations, pharmacist involvement, and worldwide stewardship practices. Packaging problems like misaligned dispensing amounts and inadequate labelling lead to excess medications and self-treatment behaviours. The analysis highlights the necessity for interdisciplinary approaches that combine pharmaceutical advancements, enhanced regulation, and pharmacist-directed stewardship efforts. Strategies like simplified dosage schedules, unit-dose packaging, and patient-focused labelling could enhance compliance and diminish antimicrobial resistance.