Rising antimicrobial resistance cause of concern: Expert

Mumbai: Rising antimicrobial resistance (AMR) is a major cause of concern for India with estimation that annually more than 10 million will die from AMR by 2050, higher than the deaths due to HIV, Tuberculosis and Malaria put together, said Dr Prapti Gilada, a Mumbai-based clinical microbiologist, who is Convener, AMR Cell, Peoples Health Organisation-India (PHO).

Citing the ICMR report in Mann Ki Baat, Prime Minister Narendra Modi’s clarion call highlighting indiscriminate use of antibiotics as a key driver of AMR has reignited the fight against AMR not only in India but globally, as over 80 percent antibiotics used in world are made in India.

“Globally, about 700,000 people lose the battle to AMR every year, killing more people than cancer and road traffic accidents combined together. The scenario is no different for India. According to some reports, more than 70 per cent isolates of some common bacteria were resistant to frequently used antibiotics. That means if a person gets a common urinary tract infection, several of the otherwise routinely prescribed, oral drugs will be rendered ineffective, necessitating higher and injectable antibiotics. It is estimated that annually more than 10 million will die from AMR by 2050, more than the deaths due to HIV, Tuberculosis and Malaria put together,” said Dr Gilada.

According to her, antibiotics are frequently prescribed and taken for viral infections, despite the fact that they are effective only against bacteria and not viruses. “The Covid-19 pandemic starkly highlighted this misuse, with widespread and unnecessary antibiotic consumption. In India, over-the-counter (OTC) sale of antibiotics—often coerced by pharmacists or based on old prescriptions that once provided relief—is a common practice. Inappropriate antibiotic selection, inadequate dosing, and the incomplete treatment, once symptoms improve, have all accelerated the emergence of drug-resistant “superbugs”,” she said.

“Antibiotics are extensively used in livestock and poultry production to prevent and control disease, to treat infections, and, in some settings, in sub-therapeutic doses to promote growth. Of concern is the fact that many of these antibiotics are identical or closely related to those used in human medicine. Such widespread use creates selective pressure that promotes the emergence of resistant bacteria in animals, contributing to primary AMR,” Dr Gilada said, pointing out the threats.

“With the ever-increasing burden of AMR, we are left with very limited options to treat such patients. The pipeline for new antibiotics is nearly dry, as research and manufacturing in this area are far less profitable for pharmaceutical companies compared to drugs for chronic diseases,” she said.

“As a result, we are, in many ways, moving toward a pre-antibiotic era—one in which people died from untreatable bacterial infections. The realization that even we, and our loved ones, could face such outcomes should serve as a serious wake-up call for all of us,” she added.