Can Antibiotic Resistance Turn A Simple Surgery Into A Serious Risk? Experts Answer

A routine appendix removal, Caesarean section or knee replacement is generally considered safe today, thanks to advances in surgical techniques, anaesthesia and antibiotics. But infectious disease experts warn that one growing threat could undermine these medical achievements: antibiotic resistance. Antibiotics have transformed surgery by preventing and treating infections before they become life-threatening. However, as bacteria become increasingly resistant to commonly used antibiotics, even routine operations may carry greater risks. Doctors say this isn't a future concern; it's already happening in hospitals worldwide. According to the World Health Organisation (WHO), antimicrobial resistance (AMR) is among the top global public health threats. Drug-resistant bacterial infections were directly responsible for an estimated 1.27 million deaths and associated with nearly 4.95 million deaths worldwide in 2019, highlighting the scale of the problem.

"Simple surgery is only as safe as we can prevent and treat infection," says Dr. Aparna Chakravarty, Professor of Pediatric Infectious Disease, Amrita Hospital, Faridabad. "Modern surgery has been made possible by antibiotics for decades. But the rapid rise of antibiotic resistance is beginning to change that. When bacteria become resistant to commonly used antibiotics, infections from routine procedures can become difficult to treat, resulting in longer hospital stays, repeat surgeries, admission to intensive care, and, in some cases, death," says Dr Chakravarty.

Why Are Antibiotics So Important During Surgery?

Every surgical procedure carries some risk of infection because the body's natural protective barrier the skin is temporarily broken. To minimise this risk, doctors often administer antibiotics before surgery and, in selected cases, continue them afterward. These medicines help prevent bacteria from entering the surgical site and causing serious complications.

When antibiotics work effectively, infections can usually be treated quickly. But if the bacteria are resistant, treatment becomes far more difficult.

Also read: Antibiotic Resistance vs Antibiotic Tolerance: Why Knowing The Difference Matters

What Is Antibiotic Resistance?

Antibiotic resistance occurs when bacteria evolve mechanisms that allow them to survive medicines designed to kill them. This doesn't mean the body becomes resistant it means the bacteria do. Over time, these resistant bacteria continue multiplying, making common antibiotics ineffective. Doctors may then have to rely on stronger, more expensive medicines that may have more side effects and are not always successful.

According to Dr. Neha Rastogi, Senior Consultant, Infectious Diseases, Fortis Memorial Research Institute, Gurugram, resistance is largely driven by inappropriate antibiotic use. Surgical site infections are among the most common healthcare-associated infections. If the bacteria causing these infections are resistant to antibiotics, treatment becomes far more challenging.

Which Surgeries Could Be Affected?

Experts say antibiotic resistance doesn't just affect complex operations. Even routine procedures may become riskier, including:

• Appendix surgery
• Caesarean sections
• Joint replacement surgery
• Gallbladder removal
• Hernia repair
• Fracture fixation surgery

Beyond surgery, many other medical treatments depend on effective antibiotics. These include:

• Cancer chemotherapy
• Organ transplantation
• Neonatal intensive care
• Dialysis
• Treatment of severe burns

Without reliable antibiotics, these procedures become significantly more dangerous because patients are more vulnerable to infections.

Why Is India Particularly Vulnerable?

India carries one of the world's largest burdens of antibiotic-resistant infections. The Indian Council of Medical Research (ICMR) has repeatedly reported increasing resistance among common bacteria such as:

1. Escherichia coli (E. coli)
2. Klebsiella pneumoniae
3. Acinetobacter baumannii

These bacteria are responsible for many hospital-acquired infections, urinary tract infections, bloodstream infections and post-surgical complications. As resistance increases, some of the antibiotics doctors have relied upon for decades are becoming less effective.

Who Faces The Greatest Risk?

Although anyone undergoing surgery can develop an infection, certain groups are more vulnerable, including:

• Older adults
• People with diabetes
• Patients with obesity
• Individuals with weakened immune systems
• Cancer patients
• Organ transplant recipients
• Premature newborns

In these individuals, infections can progress rapidly and become difficult to control if resistant bacteria are involved.

Can Antibiotic Resistance Be Prevented?

Experts say tackling antimicrobial resistance requires action from hospitals, doctors and patients alike. Hospitals are strengthening infection-control measures through:

1. Better sterilisation techniques
2. Strict hand hygiene
3. Isolation of infected patients when needed
4. Antibiotic stewardship programmes that promote responsible prescribing

Researchers are also working to develop new antibiotics and alternative treatments, but experts caution that prevention remains the best strategy.

Also read: A Single Antibiotic Dose May Disrupt Gut Health Even After 4 To 9 Years, Says New Study

What Can Patients Do?

Patients also play an important role in slowing antibiotic resistance. Doctors recommend:

1. Never taking antibiotics without a prescription.
2. Avoiding antibiotics for viral illnesses such as the common cold or flu.
3. Completing the full prescribed course, even if symptoms improve.
4. Never sharing leftover antibiotics with others.
5. Following all pre- and post-operative instructions carefully.
6. Maintaining good personal hygiene before and after surgery.
7. Keeping vaccinations up to date to reduce infection risk.

"The responsible use of antibiotics is required to prevent this crisis," says Dr. Aparna Chakravarty. She advises not to take antibiotics for a viral infection such as the common cold or the flu. Don't self-prescribe antibiotics. Take all the antibiotics that have been prescribed for you. Hand hygiene, vaccination and strict infection control practices in hospitals and antibiotic stewardship programmes are also key." She adds, "Saving antibiotics today is saving the safety of even the most basic surgery tomorrow." Modern surgery remains remarkably safe, but its success depends heavily on antibiotics that can effectively prevent and treat infections. As antimicrobial resistance continues to rise globally, experts warn that procedures once considered routine could become increasingly challenging. Responsible antibiotic use, stronger infection-control practices and greater public awareness are essential to preserving these life-saving medicines. Protecting antibiotics today will help ensure that tomorrow's surgeries from simple operations to life-saving transplants remain as safe and effective as possible.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.