A new, large-scale international study published in the prestigious Lancet eClinical Medicine journal has sounded a "loudest alarm bell" on the antibiotic resistance crisis in India, revealing that 83% of Indian patients carry multidrug-resistant organisms (MDROs).
The study, co-authored by researchers from AIG Hospitals, warns that India is at the epicentre of a superbug explosion, necessitating immediate policy changes and a national movement on antibiotic stewardship.
The findings were released to coincide with Antimicrobial Stewardship Week from November 18 to November 25. The hope is to bring attention to the urgent need for responsible antibiotic use to become a national priority.
The multicentre study, which analysed over 1,200 patients across four countries, found that the MDRO carriage rate in Indian patients undergoing a common endoscopic procedure (ERCP) was the highest reported among all participating nations.
In India, 83% of patients carried MDROs in Italy, 31.5%, in the United States 20.1% and in the Netherlands 10.8%.
The resistant bacteria discovered in Indian participants included 70.2% with ESBL-producing organisms, that means common antibiotics won't work, and a staggering 23.5% with carbapenem-resistant bacteria, which are resistant even to last-resort antibiotics.
The study highlights that this dramatic prevalence cannot be explained by medical history or underlying illnesses alone, even after adjusting for age and comorbidities.
Dr. D. Nageshwar Reddy, Chairman of AIG Hospitals and co-author of the study, said, "When over 80% of patients... are already carrying drug-resistant bacteria, it means the threat is no longer limited to hospitals, it is in our communities, our environment, and our daily lives."
This suggests a deep-rooted community-level problem linked to factors such as antibiotic misuse, easy over-the-counter availability of antibiotics without prescription, incomplete treatment courses and widespread self-medication.
The presence of MDROs forces hospitals to use stronger and more toxic drugs, prolongs recovery, increases the risk of complications, and leads to substantially higher treatment costs.
Dr. Reddy provided a compelling real-life example of the impact. A non-MDR (multidrug-resistant) patient with a severe infection recovered quickly on standard antibiotics, was discharged in about 3 days, and incurred an overall cost of roughly INR 70,000.
In contrast, an MDR patient with the same problem did not respond to first-line antibiotics, required escalation to high-end drugs, developed sepsis needing ICU care, stayed for over 15 days, and had a total cost that rose to INR 4-5 lakh.
For India, where nearly 58,000 newborn deaths each year are linked to resistant infections, and where untreatable bacteria are frequently encountered in ICUs and cancer centers, the study provides "unmistakable evidence that antimicrobial resistance (AMR) has become a national health emergency".
The study's authors call on policymakers and healthcare institutions to treat this not as an isolated warning, but as strong evidence requiring urgent action.
Immediate reforms called for include strict prescription-only antibiotic policies. Dr Nageswar says nationwide, there should be antibiotic stewardship programmes, digital tracking of antibiotic use, stronger pharmacy regulations and mass public-awareness campaigns.
Also needed is a comprehensive One Health approach addressing antibiotic misuse in humans, livestock, agriculture, and sanitation, he says.
Dr. Reddy has also suggested six key actions the general public must follow diligently to help slow the spread of resistance:
- Never take antibiotics without a doctor's prescription
- Avoid self-medication, pharmacy-driven antibiotics, and leftover tablets.
- Don't demand antibiotics for viral illnesses, pointing out that antibiotics are ineffective against most fevers, colds, and coughs.
- Always complete the full antibiotic course: Stopping midway allows bacteria to become stronger and resistant.
- Maintain strong hygiene habits: Regular handwashing, clean drinking water, and safe food handling reduce infections and the need for antibiotics.
- Keep vaccinations up to date: Vaccines prevent infections, which means fewer antibiotics are needed.
- Handle pets and livestock responsibly: Do not use antibiotics in animals without veterinary advice, as resistant bacteria can spread between animals and humans.
The authors warn that without immediate intervention, India risks entering a post-antibiotic era where common infections, routine surgeries, and everyday medical procedures could become life-threatening. The study, they conclude, is a critical wake-up call for all stakeholders to act swiftly before the crisis deepens irrevocably.
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.
