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The World Health Organisation has recently released the ‘WHO 2025 Global Antibiotic Resistance Surveillance Report’ which underscored the escalating global threat of antimicrobial resistance (AMR) particularly for low- and middle-income countries including India. According to the report, one in six laboratory-confirmed bacterial infections causing common infections in people worldwide in 2023 were resistant to antibiotic treatments. Between 2018 and 2023, antibiotic resistance rose in over 40 per cent of the pathogen-antibiotic combinations monitored, with an average annual increase of 5-15 per cent. Data from over 100 countries has cautioned that increasing resistance to essential antibiotics poses a growing threat to global health. For the first time, the report presents resistance prevalence estimates across 22 antibiotics used to treat infections of the urinary and gastrointestinal tracts, the bloodstream and those used to treat gonorrhoea. The new report notes that drug-resistant Gram-negative bacteria are becoming more dangerous worldwide, with the greatest burden falling on countries least equipped to respond. Among these, E. coli and K. pneumoniae are the leading drug-resistant Gram-negative bacteria found in bloodstream infections. These are among the most severe bacterial infections that often result in sepsis, organ failure, and death. Yet more than 40 per cent of E. coli and over 55% of K. pneumoniae globally are now resistant to third-generation cephalosporins, the first-choice treatment for these infections. Other essential life-saving antibiotics, including carbapenems and fluoroquinolones, are losing effectiveness against E. coli, K. pneumoniae, Salmonella, and Acinetobacter. Carbapenem resistance, once rare, is becoming more frequent, narrowing treatment options and forcing reliance on last-resort antibiotics. And such antibiotics are costly, difficult to access, and often unavailable in low- and middle-income countries. The latest findings indicate that resistance to last-resort antibiotics is also rising, which means existing treatments are failing.
The situation is grim as the world today is literally standing on the edge of a post-antibiotic era - a world without antibiotics, in which illnesses from minor throat infections to serious illnesses like cholera, tuberculosis, pneumonia, etc are untreatable. No doubt, AMR is gradually but definitely proving to be a gathering storm that threatens a Century of progress in medicine. It is outpacing advances in modern medicine, threatening the health of families worldwide. Experts in the field have already red flagged over the looming grim situation of a world without antibiotics, if necessary steps are not taken immediately. Even though AMR also occurs naturally over time, indiscriminate use of antibiotics is one of the major reasons for the emergence of AMR. It is often observed that the availability of these life-saving medicines over-the-counter makes matters worse as people tend to purchase antibiotic drugs even for illnesses which are due to a virus rather than a bacterium. When antibiotics are so readily available, there is no imperative for them to be treated with the care they needed. Yet another fact is that the burden of AMR falls disproportionately on low- and middle-income countries, where healthcare systems are overburdened, and resources are stretched. The gravity of the impending situation can be gauged from some earlier reports that nearly 2 million deaths are projected in India due to AMR by the year 2050 as the country has some of the highest antibiotic resistance rates among bacteria that commonly cause infections, both in the community and healthcare facilities. Quite obviously, the global community has declared AMR as a public health crisis and the regulators world over, including the Indian regulators, have already initiated measures to tackle the issue on war footing as they are seized of the grim scenario. And this is not the health crisis of the present generation alone, as it is going to be the biggest health crisis of the next generation too, if not tackled in time.
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