Fake antibiotics and antibiotic resistance: why it matters to every family
A fake or weak antibiotic harms more than the person who takes it: it fails to cure the infection and helps bacteria become resistant, which makes real antibiotics work less well for everyone. Checking the pack and using antibiotics properly are two things every family can do about it.
What DRAP has found
Antibiotics appear again and again in DRAP's alerts. In June 2026, tablets sold as Novidat 500 mg, a ciprofloxacin brand, were declared spurious after testing found 0.00 mg of the antibiotic in each tablet. Other alerts have named falsified versions of widely used brands such as Velosef and Augmentin. You can look up any antibiotic by name or batch in our recall search.
How bad antibiotics breed resistance
| What is in the tablet | What happens to the patient | What happens to the bacteria |
|---|---|---|
| No antibiotic | Infection continues and may spread | Multiply freely and pass to other people |
| Too little antibiotic | Feels a little better, then relapses | The weak die, the tough survive and take over |
| The wrong antibiotic | No benefit, possible side effects | Exposed to a drug for no reason |
Why Pakistan is especially exposed
Pakistan has already lived through what resistance looks like. An outbreak of extensively drug-resistant (XDR) typhoid that began in Sindh in 2016 left doctors with very few antibiotics that still worked against it. Easy over-the-counter sales, self-medication, incomplete courses and poor-quality products all push in the same direction.
What you can do
- Take antibiotics only when prescribedThey do nothing for colds, flu and most sore throats, which are caused by viruses.
- Check the packScan the square code, and check the seal, batch and expiry. Buy from a licensed pharmacy.
- Take the dose and duration your doctor prescribedDo not stop early because you feel better, and do not save leftovers for next time.
- Never share antibioticsThe right drug and dose depend on the infection and the person.
- Go back if it is not workingTell your doctor after two or three days without improvement, and bring the pack.
If you suspect a pack is fake, report it. Reports from patients and doctors are how batches like the ones above get tested.
Antibiotics named in DRAP alerts
Using our index of DRAP's alerts, we counted spurious and substandard alerts that mention common antibiotics such as ciprofloxacin, cephalosporins, amoxicillin and its combinations, and azithromycin. The numbers rose sharply: one alert in 2022, one in 2023, two in 2024, thirteen in 2025 and eight by mid-November 2026. Part of that rise reflects more testing and reporting, not only more fakes, but it is a clear signal to take antibiotic packs seriously. Search any antibiotic by name or batch in our recall tool.
How resistance spreads beyond one patient
Resistance is not something that happens inside one body and stays there. Resistant bacteria pass between family members, through hospitals and through water. A child given fake antibiotics at home can carry resistant bacteria to school; a patient whose infection was poorly treated can bring them into a ward. That is why WHO describes antimicrobial resistance as one of the top global public health threats, and why a single fake pack is everybody's problem.
Signs your antibiotic may not be working
- No improvement at all after two or three days of a correctly taken course.
- Fever returning soon after finishing the course.
- The tablets look, smell or taste different from a previous pack of the same brand.
- Capsules that are half empty, or tablets that crumble.
- A syrup powder that will not dissolve properly when water is added.
Any of these is a reason to call your doctor, take the pack with you, and scan it. Do not simply buy a stronger antibiotic yourself.
Myths that drive misuse
| Myth | Reality |
|---|---|
| "Antibiotics cure colds and flu." | Colds and flu are caused by viruses. Antibiotics do nothing for them. |
| "Stop when you feel better." | Take the course exactly as your doctor prescribed, unless the doctor tells you otherwise. |
| "A stronger antibiotic is a better antibiotic." | Broad, powerful antibiotics are kept for when they are needed; using them early speeds resistance. |
| "Keep leftovers for next time." | The next illness may need a different drug, dose or no antibiotic at all. |
| "The cheapest pack is the same medicine." | Far-below-MRP prices are a common sign of fake stock. Check the official price in our price search. |
Children's antibiotic syrups
Many antibiotic suspensions for children come as dry powder. Fakes and heat damage both show up here: the powder may be clumped, discoloured or not mix properly. Use clean, boiled and cooled water to the line on the bottle, shake well, keep it as the label says (often in the fridge), and discard what is left at the end of the course or by the date on the label, whichever comes first. Check expiry and seal before buying; more in reading expiry dates.
What doctors and pharmacies can do
- Prescribe antibiotics only when a bacterial infection is likely, and say how long to take them.
- Scan antibiotic stock on arrival; see our pharmacy scanning routine.
- Report treatment failures with the batch number, because a cluster from one batch is a strong quality signal.
Antibiotic nakli to nahin?
Antibiotic sirf doctor ke kehne par lein, poora course karein aur bachi hui goliyan agli dafa ke liye na rakhein. Dabbay ka code scan karein aur batch number recall alerts mein dekhein. Agar do teen din mein faida na ho to doctor ko pack dikhayein.
Questions people ask
What is antibiotic resistance?
It is when bacteria change so that an antibiotic no longer kills them. Infections that used to be easy to treat then need stronger, costlier medicines, and some become very hard to treat at all.
How do fake antibiotics cause resistance?
A tablet with too little antibiotic kills the weakest bacteria and leaves the strongest alive to multiply. A tablet with none at all leaves the infection untreated, so the patient stays ill longer, spreads it to others and often ends up on several more antibiotics.
Can I buy antibiotics without a prescription?
Antibiotics are prescription medicines. Taking them without a diagnosis, for colds or flu, or stopping and starting them, is one of the main drivers of resistance.
My antibiotic is not working. Could it be fake?
Possibly, but there are other reasons: the infection may be viral, or the bacteria may already be resistant. See your doctor, take the pack with you, and scan it.
Which antibiotics are most often faked in Pakistan?
DRAP alerts have named fakes of widely used brands, including ciprofloxacin, cephalosporin and amoxicillin-clavulanate products. Fakes follow demand, so any fast-selling antibiotic can be targeted.
What is XDR typhoid?
Extensively drug-resistant typhoid is a form of typhoid fever that does not respond to most of the antibiotics normally used for it. An outbreak began in Sindh in 2016, and it is one of the clearest examples of antibiotic resistance in Pakistan.
Can I buy antibiotics without a prescription to save time?
You should not. Self-treatment is a leading cause of resistance, you may pick the wrong drug, and an untreated or wrongly treated infection can become serious.
Should I stop my antibiotic if I suspect the pack is fake?
Do not just stop and do nothing. Contact your doctor or pharmacist the same day, get a pack you can verify, and continue the course with it. An untreated infection is a risk in itself.
