BACKGROUND: In India, antibiotic resistance is high and by 2050, two million people will be affected. OBJECTIVE: To review antibiotic practices in India and the variables that impact them. METHODS: For this narrative review, research articles on antibiotic awareness, perception and practices were retrieved from PubMed and Google Scholar using search terms such as ‘India AND antibiotic use AND cross sectional AND awareness’. A total of 1730 results were found on 30 June 2020, of which 35 articles were eligible for summarizing the common antibiotic practices. RESULTS: We found that there are deficiencies in the implementation of existing policies in India. Several issues such as overprescribing of antibiotics, use without prescription and non-adherence to treatment regimens are contributing to irrational antibiotic practices in the country. CONCLUSION: There is a need for policies at the institute level to help curb the problem of antibiotic resistance.