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Context:

Prime Minister Narendra Modi recently made a strong appeal for the responsible use of antibiotics. Referring to a recent report, he cautioned that antibiotics are becoming increasingly ineffective against common infections such as pneumonia and urinary tract infections. 

What is Antimicrobial Resistance (AMR)?

Antimicrobial Resistance occurs when disease-causing microorganisms — including bacteria, viruses, fungi, and parasites — evolve to withstand medicines that previously eliminated them. This resistance reduces the effectiveness of treatments such as antibiotics, antivirals, antifungals, antimalarials, and anti-parasitic drugs, making infections harder to cure.

Reasons contributing to the spread of AMR:

Several interconnected factors contribute to the rapid rise of AMR:

• High infectious disease burden in many countries leads to frequent antibiotic use, increasing the risk of resistance.
• Limited diagnostic infrastructure often prevents doctors from identifying the exact pathogen, leading to broad or unnecessary antibiotic prescriptions.
• Poor sanitation and infection control in healthcare settings allow resistant organisms to spread easily.
• Misuse of antibiotics, including self-medication, incomplete treatment courses, and overuse of broad-spectrum drugs, accelerates resistance.
• Low public awareness about appropriate antibiotic use further worsens the problem.

Current status on Antibiotic use and resistance:

• Overuse and inappropriate prescribing of antibiotics have been identified as a major factor driving antimicrobial resistance (AMR).
• Around 55% of patients were given antibiotics as a preventive measure, even when no confirmed infection was present.
• Only about 6% of cases involved antibiotics prescribed after laboratory confirmation of the specific bacteria causing the illness.
• A vast majority of prescriptions nearly 94% were empirical, meaning treatment started before a clear diagnosis was established.
• The share of patients receiving antibiotics showed wide variation (37% to 100%) across different healthcare settings, indicating a lack of uniform prescribing standards.

Consequences of Antimicrobial resistance:

AMR poses serious threats to health systems and economies:

• It undermines treatment of common infections such as pneumonia, urinary tract infections, and skin diseases. In 2019, infections were linked to about 13.7 million deaths globally, with AMR directly responsible for 27 million deaths and contributing to nearly 5 million more.
• Drug-resistant infections often require longer hospital stays, costlier medicines, and more complicated therapies.
• Routine medical procedures like surgeries, cancer chemotherapy, and organ transplants become riskier due to the threat of untreatable infections.
• As resistance spreads, the number of effective antibiotics continues to shrink.

Measures taken to combat AMR:

National Initiatives

• National Programme on AMR Containment (2012): Strengthens laboratory-based surveillance in medical colleges.
• National Action Plan on AMR (2017): Adopts a One Health approach, integrating human, animal, and environmental health sectors.
• AMR Surveillance and Research Network (AMRSN): Monitors resistance patterns nationwide to guide treatment policies.
• Drug Regulation Measures: The Drug Controller General of India has banned 40 irrational fixed-dose antibiotic combinations.

Global Efforts

• World Antimicrobial Awareness Week (WAAW): An annual WHO-led campaign to promote responsible antimicrobial use.
• Global Antimicrobial Resistance and Use Surveillance System (GLASS): A WHO initiative to gather and analyze global AMR and antibiotic usage data.

Way Forward:

• Increase Public Awareness: Educate communities about the dangers of misuse and overuse of antibiotics.
• Strengthen Antibiotic Stewardship: Hospitals should implement structured programs to monitor and rationalize antibiotic prescriptions.
• Tighten Drug Sales Regulations: Ensure antibiotics are sold only with valid prescriptions.
• Promote Research and Innovation: Encourage development of new antibiotics, rapid diagnostic tools, and alternative treatments such as phage therapy.
• Expand Surveillance Systems: Build an integrated national network to track resistance trends across humans, animals, and the environment.

Conclusion:
Antimicrobial resistance is a growing global health crisis that threatens the effectiveness of life-saving medicines and makes common infections harder and more expensive to treat. Combating AMR requires responsible antibiotic use, stronger surveillance, improved infection control, and sustained investment in research, awareness, and global cooperation.

Source: Business line