Antibiotics

Main article: Immune system

How Antibiotics Reduce Immunity

Human health is directly related to the immune system. Immunity is a combination of the body's reactions to various pathogens - genetically foreign objects. They can be bacteria, viruses, fungi, parasites, as well as body cells that have died or mutated, for example, into cancer cells. Decreased immunity, or immunodeficiency - a group of pathological conditions in which the immune system does not work properly. This leads to exacerbation of chronic infections or to the transition of acute infectious diseases into a chronic form, which forms secondary immune failure (VIN).

The reason for the decrease in immunity is the deterioration of the environment, irrational nutrition, stress, psychoemotional loads, as well as uncontrolled use of antibiotics, which affects the microflora of the body, which is part of the immune system. Because of the widespread spread, antibiotics become less effective and pathogens become more resistant to them.

So from 2000 to 2015, the global consumption of antibiotics in medicine increased by 65%^[1]. For 2021, therapy for more infections, such as pneumonia, tuberculosis, blood infection becomes more difficult due to the growth of antimicrobial resistance, and about 700 thousand people die from such infections in the world^[2].

Bacteriophages

Main article: Bacteriophages

Antibiotics only treat bacterial infections

 Are antibiotics an effective means of preventing and treating coronavirus infection?

No, antibiotics against viruses do not work. They only allow you to treat bacterial infections.

 CoronavirusCOVID-19 is a virus, and therefore antibiotics should not be used to prevent and treat coronavirus infection.

However , patients hospitalized with the infection may be prescribed antibiotics to treat concomitant bacterial infections.

2026: Scientists create'smart' delivery of antibiotics straight to the lungs

Scientists at NRNU MEPhI, together with colleagues from other scientific organizations, presented a system of "smart" delivery of antibiotics directly to the lungs. To deliver the antibiotic rifampicin, it is proposed to use nanomaterials - metal-organic scaffolds (MOX). Among the authors of the development are Professor of the Department of Translational NRNU MEPhI Sergei Deyev, student of NRNU MEPhI Danila Pokhorukov and a graduate of MEPhI, an employee of the Laboratory of Molecular Immunology of the IBH RAS Olga Gryaznova. The work was carried out with the support of the Russian Science Foundation. The results of the study are published in the international scientific journal Biomedical Materials. About this on February 9, 2026, representatives of MEPhI. Read more here.

2025: Growth in sales of antibiotics in Russia by 7.4% to 44.2 billion rubles

On February 9, 2026, RNC Pharma released data on the state of the Russian retail market for systemic antibacterial drugs. The market volume in monetary terms in 2025 amounted to over 44.2 billion rubles, which is 7.4% more than in 2024.

In physical terms, 167.5 million packages or 1.24 billion minimum dosage units (MED) were sold. At the same time, the physical demand for antibiotics has been declining for the third year in a row: in 2025, the fall was 2.8% in packages.

Three groups of antibiotics form the basis of sales by volume (more than 78%): cephalosporins (36.3%), broad-spectrum penicillins (23.5%) and macrolides (18.2%). The most significant growth in 2025 was shown by the rifampicin subgroup, whose sales increased by 46% in rubles and by 35% in packages. Beta-lactam antibiotics, such as meropenem and aztreonam, also showed positive dynamics with an increase of 17% and 14%, respectively.

The market leader in terms of money volume remains the Amoxiclav drug of Sandoz, its share is 16% in the group. Sales of this brand increased by 32% in rubles. The second position is taken by Pancef from Alkaloid with an increase of 11%. Among the most dynamically growing drugs in physical terms are Suprax from Cheplafarm, whose sales increased by 65% in packages.

At the same time, there is a trend of a shift in demand towards original branded drugs. While such drugs show growth, unbranded analogues such as those based on azithromycin, ceftriaxone and levofloxacin show negative sales dynamics.

There is a limited number of new products on the market. One of these drugs is the combined antibiotic Amblavio (aetreonam + avibactam) of Pfizer, designed to counter Gram-negative bacteria.^[3]

2024

Antibiotic production in Russia for the year increased by 9.3% to 3.4 thousand tons

The production of antibiotics in Russia in 2024 reached 3.4 thousand tons, an increase of 9.3% compared to 2023 and amounting to 109.3% of the level of the previous 2023. This is evidenced by the data of the analytical company Alto Consulting Group, released in October 2025.

The record figure in recent years is associated with an increase in domestic demand for drugs, an expansion of the production capacity of pharmaceutical companies and government support for the industry. The Volga Federal District became the absolute leader in the production of antibiotics, providing 88.7% of the total production.

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Reasons for production growth:

• Growth of domestic demand for drugs.
• Expanding the production capacity of pharmaceutical companies.
• Government support for the industry.

The high concentration of output in the Volga Federal District is explained by the presence of large pharmaceutical enterprises. The developed infrastructure of the region ensures the availability of raw materials and energy resources. Proximity to transport corridors provides convenient access to sales markets both domestically and for export.

In addition to the Volga District, growing capacities are observed in the Central and North-Western Federal Districts. Midsize enterprises are focused on the domestic market and exports. The development of transport and logistics infrastructure contributes to the growth of antibiotic exports.

In the period 2022-2024, the largest increase in prices was observed in 2024. For amoxicillin with clavulanic acid, 500 mg + 125 mg, the growth rate was 16.8%. The growth is associated with an increase in the cost of raw materials, inflationary processes and modernization of production.

The average retail price in May 2025 was ₽278,1 per package, an increase of 0.1% compared to April 2025. Despite the slight increase, prices remain stable. This suggests a balanced market and sustained demand for broad-spectrum drugs.^[4]

Growth in sales of antibacterial drugs in Russia by 11% to ₽41,1 billion

Sales of systemic antibacterial drugs in Russia in 2024 increased by 11% and exceeded ₽41,1 billion in retail prices. This is evidenced by the data of the analytical company RNC Pharma on the results of an audit of retail sales of medicines in Russia as of July 9, 2025.

According to the study, the Russian market for antibiotics in doses decreased by 0.2%, and in 2023 the negative dynamics was recorded at the level of -2.6% due to the high base of 2022. Despite the decline in physical volumes, cash sales are steadily growing.

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According to RNC Pharma, sales of systemic antibacterial drugs in January - May 2025 in the retail market of Russia exceeded ₽19,4 billion with an increase of 12.5%. Negative dynamics was recorded when calculating in the minimum dosage units - 541.6 million units were sold in five months, which is 0.6% less than the same period in 2024. The physical volume of consumption of systemic antibacterial drugs in retail has been declining for the third year in a row.

The most pronounced ruble dynamics in January - May 2025 were characterized by broad-spectrum penicillins with sales growth of 17.8%, as well as tetracyclines with long-term dynamics of 14.3%. The decrease was recorded by the groups of trimethoprim (-1%) and amphenicol (-0.1%).

The absolute leader in terms of cash sales for the period is Amoxiclav from Sandoz, which occupies 16.1% in the group and demonstrates 67% dynamics. Augmentin shows significant growth rates from GSK (+ 57%), but in terms of absolute sales, the product is in 14th position.

The largest growth rate among top-end drugs is demonstrated by Suprax from Cheplafarm with sales growth of 70%. In the period from 2020 to 2023, all three listed drugs experienced periodic difficulties with supplies due to a shortage of raw materials, the situation returned to normal in 2024.^[5]

Growth in sales of antibiotics in the world to $41.63 billion

In 2024, the global antibiotic market amounted to $41.63 billion. Moreover, more than 45% of global sales fell on the North American region. This is stated in a study by Fortune Business Insights, the results of which were published in early June 2025.

The sector in question is showing sustained positive dynamics, which analysts say is due to an increase in the prevalence of bacterial infections. These may include urinary tract infections, respiratory infections, tuberculosis, skin infections, sexually transmitted diseases, etc. So, according to estimates by the World Health Organization (WHO), in 2023, tuberculosis was diagnosed in about 8.2 million new patients - this is the highest figure since 1995. However, the spread of multidrug-resistant tuberculosis remains a public health crisis.

The study says that the widespread use of antibiotics leads to the emergence of bacteria with resistance to antimicrobials. For example, according to the WHO, more than 60% of Neisseria gonorrhoeae isolates (gonococcus, causes) gonorrhea show resistance to one of the most widely used oral antimicrobials, ciprofloxacin. And over 20% of E. coli () isolates E. coli are resistant to both first-line drugs (ampicillin and co-trimoxazole) and second-line drugs (fluoroquinolones).

Antimicrobial resistance undermines modern medicine and endangers the lives of millions of people, says WHO Director-General Dr Tedros Ghebreyesus.

At the same time, the authors of the study note, the emergence of antimicrobial resistant bacteria creates profitable opportunities for market participants in terms of the development of new advanced combination therapies. There has been an increase in demand for innovative therapies, leading to increased investment in research and development aimed at creating and bringing therapeutically effective antibiotics to market.

According to the class of drugs, the industry is segmented into cephalosporins, penicillins, aminoglycosides, macrolides, tetracyclines, fluoroquinolones, sulfonamides, etc. In 2024, the penicillin sector dominated, driven by the increasing prevalence of bacterial infections. Depending on the scope of use, infections of the skin, respiratory tract, urinary tract, sepsis, ear infections, gastrointestinal infections, etc. are distinguished. The largest share of revenue was provided by the respiratory tract infections segment. According to the method of administration, drugs are divided into oral, parenteral, etc. In 2024, the parenteral segment occupied the main part of the market: rapid absorption and increased bioavailability of such a dosage form, as well as preference for severe infections such as sepsis, pneumonia and bloodstream infections, where high concentrations of antibiotics are required, stimulate the demand for such drugs.

Geographically, North America leads, accounting for 45.14% of revenue, or $18.79 billion. Significant players on a global scale are named:

• Pfizer;
• Abbott;
• GSK;
• Sandoz Group AG;
• Bayer AG;
• Bristol-Myers Squibb Company;
• Merck & Co.;
• Astellas Pharma;
• Johnson&Johnson Services (Janssen Pharmaceuticals);
• AbbVie.

In 2025, antibiotic sales are expected to reach $43.17 billion. Fortune Business Insights analysts believe that in the future, the CAGR will be 4.4%. Thus, by 2032, the volume of the industry may increase to $58.24 billion.^[6]

Why the effectiveness of antibiotics is declining around the world. Scientific explanation

The effectiveness of antibiotics is rapidly declining around the world, which can result in serious problems for the health sector. This is stated in the materials published on October 20, 2024 by the German newspaper Bild.

Scientists note that the fight against disease-causing bacteria is part of human history. The age of modern antibiotics actually began in September 1928 with the accidental discovery of the British microbiologist Alexander Fleming, who first isolated penicillin from the mold fungi Penicillium notatum. Fleming subsequently stated that penicillin should not be used for a short time and in very small amounts, since in such cases bacteria develop resistance to antibiotics. This is one of the reasons for the decrease in the effectiveness of such drugs.

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We are on the verge of losing the achievements of modern medicine and returning to the times leading up to the discovery of penicillin, says Mathias Pletz, president of the German Paul Ehrlich Society for Infectious Therapy (PEG).

Professor Frank Brunkhorst from the University Hospital of Jena cites two main reasons that provoke a deterioration in the effectiveness of antibiotics. One of them is the too frequent prescription of these drugs, especially on an outpatient basis. In addition, large numbers of drug-resistant microbes migrate between countries. This problem has become especially relevant amid the lifting of severe restrictions imposed in the context of the COVID-19 pandemic .

In particular, in countries such as Greece, Portugal and Turkey, as well as in India and other Asian states, the level of antibiotic resistance is extremely high, Brunkhorst emphasizes.[7]

2023

Increase in antibiotic production by 60% to 1,621 tons

At the end of 2023, 1,621 tons of antibiotics were produced in Russia. This is about 60% more compared to 2022, when the volume of output was estimated at 1007 tons. This is stated in the study of the Business Profile group, the results of which were published on February 4, 2025.

It is noted that the production of antibiotics in the Russian Federation has been showing positive dynamics since 2018, when 377 tons of drugs were manufactured. In 2019, the figure increased to 555 tons, and at the end of 2020 amounted to 560 tons. In 2021, production growth was recorded to 704 tons.

The current geopolitical situation contributes to the development of the industry under consideration. The course of the Russian industry on import substitution and accompanying state support led to an increase in the share of domestic antibiotics in the market, as well as an increase in export supplies. In addition, research is underway to find new mechanisms of action of antibiotics.

The study says that a number of state programs are being implemented in the Russian Federation to stimulate the production of antibacterial drugs, one of which is the "Development of the pharmaceutical and medical industry." It provides support for scientific research in the field of the creation of antibiotics and other drugs, the provision of subsidies and grants for the development of new technologies and the modernization of production facilities, as well as the promotion of import substitution.

However, according to the World Health Organization (WHO), the wider use of vaccines against 23 pathogens can lead to a reduction in the annual use of antibiotics by 22%, or by 2.5 billion established daily doses. At the same time, there remains an urgent need to create innovative means for treating dangerous infections that are resistant to existing antibiotics. As of 2023, 97 antibacterial drugs were at the stage of clinical trials against 80 in 2021.^[8]

Chemists have developed technology to test dairy products for antibiotics

ITMO scientists have developed technology that automatically detects the content and exact concentration of antibiotics in milk. It is based on electrochemical analysis (a highly sensitive method of detecting the necessary substances in solutions) and algorithmachine learning. The development can protect consumers of dairy products from harmful drugs. It can also be used to analyze other media - for example, to detect unwanted impurities in oil, check the quality of coffee and the authenticity of wine. The university announced this on November 29, 2023. Read more here.

Antibiotics have become useless for children

In October 2023, it was revealed that antibiotics were not helping children fight widespread diseases due to high levels of antibiotic resistance from disease.

Scientists from the University of Sydney conducted a study (its results were published in the Lancet South Asia journal) and found that a large number of antibiotics recommended for use by the World Health Organization (WHO) were less than 50% effective against diseases of children such as pneumonia, blood infection (sepsis) and meningitis. It follows that the world's antibiotic guidelines are outdated and need to be updated.

Antibiotics don't help children fight widespread diseases

The regions most affected by this are Southeast Asia and the Pacific region, where the old recommendations kill thousands of children a year.

We have no immunity from this problem - the problem of resistance to antibiotics is already on our doorstep. Antibiotic resistance is growing faster than we thought. We must urgently come up with solutions to stop the deaths of thousands of children a year, commented its chief author, Dr Phoebe Williams, on the study.

Dr. Williams also noted that the best way to address this is to dramatically increase funding for research into new antibiotics for children and infants.

WHO noted antibiotic resistance as one of the 10 most important health issues. Every year, about 3 million cases of sepsis occur among babies, while 570,000 children die from them. Some of the recommended antibiotics, such as ceftriaxone, help in only one of three cases of sepsis or meningitis; while it is widely recommended and used in Australia. Another widely used ineffective antibiotic is gentamicin, which works less than half the time.^[9]

The Ministry of Health of the Russian Federation completely excluded antibiotics from the standards of treatment of ARVI

In October 2023, the Ministry of Health of the Russian Federation published a new standard for the treatment of ARVI. This document amends the list of drugs recommended for the treatment of acute respiratory viral infections.

In particular, the Ministry of Health completely refused to prescribe broad-spectrum antibiotics for ARVI. In the previous order, the standard prescribed the administration of amoxicillin, azithromycin, cephalosporin, cefoperazone, macrolides and fluoroquinolones, etc. In addition, the use of vancomycin (an antibiotic of the glycopeptide structure) was allowed.

The Ministry of Health completely refused to prescribe broad-spectrum antibiotics for ARVI

According to the document presented in October 2023, kagocel, triazavirin, tylorone and nobazite (or amisone) were added to the number of antiviral drugs prescribed to patients with ARVI, while previously this list consisted of arbidol, ingavirin and zanamivir. Zanamivir was excluded. Cycloferon and ergoferon were added as immunostimulants, while the previous standard regulated the prescription of tiloron and anaferon to stimulate immunity.

To restore the water-electrolyte balance, the Ministry of Health recommended prescribing meglumine sodium succinate ("reamberin"), while before that patients were prescribed a complex solution of sodium lactate, solutions of potassium and sodium chloride, as well as magnesium sulfate. In addition, it is proposed to supplement the list of mucolytics prescribed to patients, which currently consists only of acetylcysteine (ACC) and ambroxol, with ascoril and bromhexine and exclude codelac from it.

The ministry advises prescribing rengalin, synecod and glycodine as antitussive drugs, and lysobact as an antiseptic for sore throats. Also in the new standard for the treatment of ARVI, according to the draft order, nasal preparations containing naphazoline, xylomethazoline and oxymetazoline and paracetamol and ibuprofen recommended at high temperature are indicated.^[10]

Half of Russians take antibiotics in self-medication

In mid-January 2023, the results of a study by the Central Research Institute of Organization and Informatization of Health of the Ministry of Health (TsNIIIZ) were published, according to which more than 70% of Russians who took antibiotics in the last six months did it incorrectly - either interrupted the course ahead of time, or self-medicated, for example, drank such drugs for sore throat or as a prevention of infections.

It turned out that over the past 12 months, 54.6% of respondents took antibiotics, of which 49.1% were self-medicated. At the same time, in the overwhelming majority, they bought antibiotics at the pharmacy without a prescription. Moreover, 73.9% quit drinking antibiotics until the end of the course, as they felt better and decided that they had already recovered.

50% of Russian residents take antibiotics without a doctor's prescription

Taking into account the intake of antibacterial drugs not as prescribed by the doctor, as well as in cases of interruption of the full course of antibiotics, 43.1% of respondents were included in the risk group for the development of antibiotic resistance, the press service of TsNIIIZ explained.

The study involved 2,725 people, of whom 45.6% were men and 54.4% were women. The distribution of participants by sex and age corresponded to the structure of the population of the Russian Federation.

The chief freelance specialist microbiologist of the Russian Ministry of Health Roman Kozlov, in a conversation with Kommersant, noted that Russians began to use antibiotics more often (including uncontrolled) during the COVID-19 coronavirus pandemic. In the first waves of the incidence of coronavirus, according to him, the consumption of antibiotics in the country increased by almost a third - by 28.4%, but "thanks to the efforts of the Ministry of Health and the professional community" by the end of 2021, it returned to "pre-pandemic" indicators.

Some people still do not know that antibiotics only work on bacteria, because it is useless to take them for viral infections, "Kozlov said.

He warned that the irrational use of antibiotics could lead to more serious problems - for example, resistance (or resistance) of microbes to antibiotics.^[11]

Antibiotics raise risk of developing bowel cancer

In January 2023, it became known that antibacterial drugs for oral administration increase the risk of developing bowel cancer. Experts revealed this connection by analyzing data for 1989-2012 and for 11.3 million people.

According to the study, Oxford University antibiotics were used by approximately 70% of patients who were later diagnosed with malignant tumors. In the intestines group without malignancies, 68.5% took antibiotics. The strongest association of antibiotics cancer and was found in patients treated with antibacterial drugs 10 years before cancer diagnosis.

Taking antibiotics raises your risk of developing bowel cancer

Also, scientists advise to abandon entire groups of products. If a person consumes red meat (beef, pork, lamb) and processed meat products on a daily basis, even in small quantities, he thereby increases the risk of developing bowel cancer.

The use of antibiotics with the risk of bowel cancer is also associated with scientists at the University of Aberdeen in Britain. About 40 thousand people took part in their study. The scientists compared the frequency of antibiotic use and the impact of other factors among those who had cancer (7,903) and those who did not (30,418). It turned out that antibiotics were not associated with rectal cancer, but their use correlated with colon cancer. At the same time, the risk increased by about 50 percent in people under the age of 50 years and by about nine percent in people aged 50 years and older.

The reason for this association is hypothesized to be the effect of antibiotics on bacterial diversity in the gut microbiome, potentially leading to altered bacterial activity and impaired normal immune function.

According to experts, the results indicate that antibiotics should be used appropriately if necessary. Previously, there were only a small number of studies examining the association of antibiotics and colon cancer, and these studies were limited to the elderly and yielded mixed results.^[12]

2022

A device has been developed to determine antibiotic sensitivity in 2 hours

On October 21, 2022, the JapaneseNara Institute of Science and Technology (NAIST) announced the development of a new high-speed test method for antibiotic sensitivity. The proposed method is expected to redefine the approach to microbial screening in clinical and research laboratories. Read more here.

Scientists have found an effective antibiotic for use with bone cement

Researchers from in Brigham Women's Health Center USA compared the effectiveness of various antibiotics that can be used with bone cement and identified the most effective that has shown promising results when used against staphylococcus. In the future, this approach could potentially be used to treat bone infections and reduce the development of bacterial resistance. The University MISIS announced this on October 19, 2022. More. here

2018: Artificial intelligence will search for new antibiotics

Main article: AI in pharmaceuticals

Antibiotic resistance is one of the big challenges of modern medicine. Thanks to the widespread use of antibiotics and non-compliance with doctor's instructions, drugs have ceased to affect bacteria, which causes problems in the treatment of both the most common everyday diseases and severe^[13] for^[14].

One technique that can cope with antibiotic resistance is the search for variants of known antibiotics. Unfortunately, this is an extremely difficult and time-consuming process. At least for people. When algorithms come into play, the question of time ceases to be so significant.

A group of Russian and American researchers has created an antibiotic algorithm that, quickly parsing databases, can open up 10 times more antibiotic options than has been discovered during the entire time of such studies in previous years. Read more here.

Notes