Seems that the Health Ministry is to set up a 13 member panel to try and curtail the use of antibiotics in India. This has been precipitated by a report of bacteria dubbed NDM 1 which is resistant to virtually every antibiotic. Antibiotics will be classified into categories such as non restricted, restricted and very restricted and strict penalties will be imposed against violators. So far so commendable. But will it work? A quick count through Drug Today which lists proprietary names that drugs are sold under showed that there are 153 names listed for Amoxycillin, 153 for a combination of Amoxycillin and Cloxacillin and an astonishing 378 names for Cefixime which is a third generation cephalosporin used in Typhoid fever which is becoming increasingly resistant to newer antibiotics. Besides this Amoxycillin is sold in combination with Serratiopeptidase, Lactobacillus, Probenecid, Bromhexine, Carbocysteine while Cefixime is sold in combination with Probenecid, Clavulanate and Cloxacillin among others. Cloxacillin is used only in Staphylococcus infections as in boils on the skin so a combination of Cefixime and Cloxacillin would presumably be indicated for a patient suffering from Typhoid and boils on the skin at the same time, a combination I have not seen in 40 years of practice. Against such competition drug companies will resort to any tactic to increase sales including supplying without vouchers and bribing doctors and chemists. India has a vast army of untrained quacks and a court in Chennai allowed Unani fellows to operate. Waste of time and money as usual.