Editorial: Superbugs, a public health menace

India is turning into a global epicentre of antimicrobial resistance, and this calls for urgent changes on how we use life-saving drugs

Indiscriminate use of antibiotics has created a major public health menace in India. Unfortunately, the widespread problem of superbugs — the bacteria that have become resistant to antibiotics due to overuse — is not being addressed by policymakers with the seriousness it deserves. India is turning into a global epicentre of antimicrobial resistance. The AMR is a condition when microbes, which are exposed to high-grade antibiotics, become used to them over time and resistant to them. This makes treating common infections difficult, increasing the risk of severe illness and death. The resistance also makes them ineffective for preventing secondary infection during surgeries and managing chronic infections. As a result, the microbes become superbugs. A recent study by PGIMER, Chandigarh, has shown that this problem is widespread in Indian hospitals, calling for urgent changes on how we use life-saving drugs. The survey, covering eight major hospitals across India, analysed data from 3,974 patients. It has been found that six out of 10 patients admitted to large hospitals were on antibiotics. Many of these medicines were from the “last-resort” category, meant to be used only when nothing else works. Worse, in many cases, they were prescribed without proper lab tests. This is problematic as overuse and misuse of antibiotics make bacteria stronger and harder to kill. Once they become resistant, common infections turn into life-threatening ones. The PGI study shows that hospitals themselves are becoming breeding grounds for such drug-resistant bacteria. India has no public database of mortality caused due to antimicrobial resistance.

The latest study only confirms what is already known through smaller studies and patient experiences — that germs in our hospitals are turning harder to treat. Unfortunately, governments have failed to act firmly against the vast market of fake and substandard medicines, which are freely available. Infections caused by certain resistant bacteria are now common in the ICUs of our hospitals. Some show resistance to more than 70 per cent of the strongest antibiotics. When these superbugs strike, patients need longer treatment, costlier drugs, and often face higher chances of death. Families are pushed into debt, and hospitals are stretched to the limit. Poorly treated waste from drug factories and hospitals adds resistant bacteria to our water and soil. These germs find their way back into our food and environment, creating a vicious cycle. Doctors must avoid unnecessary prescriptions and follow strict antibiotic rules. Providing proper sanitation, clean water and increasing public health expenditure, and better regulating the private health sector are necessary to reduce antimicrobial resistance. Though India launched the National Action Plan on Antimicrobial Resistance (NAP-AMR) in 2017 to combat the growing threat of AMR, there are several challenges in its implementation, particularly in ensuring rational use of antimicrobials and strengthening infection control practices. AMR-related illnesses can strain healthcare systems and lead to significant economic losses due to prolonged treatment and longer hospital stays.

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