Pakistan facing silent pandemic of antibiotic resistance: experts

ISLAMABAD: Irrational use of 3rd and 4th line antibiotics, particularly in hospitals, has led to the emergence of bacteria that are increasingly difficult to treat, resulting in prolonged hospital stays, higher treatment costs, and rising mortality, experts have warned.

While no concrete data exists on deaths attributed to drug resistance, thousands of lives are believed to be lost annually to infections caused by resistant pathogens. This has prompted experts to urge a multisectoral approach to combat what is being termed a silent, emerging pandemic. The experts commended the health ministry alongside the National Institute of Health (NIH) for their comprehensive efforts to combat antimicrobial resistance (AMR).

“AMR is responsible for a significant burden of infections that are increasingly difficult to treat due to drug resistance. The emergence of extensively drug-resistant (XDR) infections at the community level and the growing prevalence of hospital-acquired bloodstream infections have become harder to treat,” said Dr Muhammad Salman, executive director

of the National Institute of Health (NIH).

He was speaking at the inaugural session of the National Symposium on Antimicrobial Resistance (AMR), organized as part of the World Antimicrobial Awareness Week 2024 (WAAW) by the NIH in collaboration with the WHO, Fleming Fund, Health Services Academy (HSA), and Getz Pharma. Dr. Salman noted that the symposium, a regular NIH activity, aimed to highlight the burden of AMR in Pakistan. Walks, seminars, training sessions, and awareness campaigns are routinely held to advocate the rational use of antibiotics.

Deputy Director of Programs at the Ministry of National Health Services, Dr Atiya Abro, highlighted that AMR not only threatened human health but also endangered food security by affecting livestock and crop health. She warned that resistant pathogens reduced agricultural productivity and contributed to environmental contamination, further spreading resistance genes. The preparation of the National Action Plan 2.0 and the implementation of technical and awareness initiatives reflected a strong commitment to addressing the growing AMR threat, she said, adding that these measures, aimed at promoting rational antibiotic use and fostering public awareness, had been lauded as essential steps in safeguarding public health and preventing further resistance development.

Getz Pharma’s Lead of Public Health, Jaffer Bin Baqar, said they were working with NIH and other partners to tackle AMR by training over 15,000 healthcare providers nationwide and creating awareness about avoiding self-medication and the irrational use of antibiotics. He emphasized limiting antibiotic use to prescription-only and ensuring adherence to prescribed dosages and durations.

Senior NIH scientist and AMR lead, Dr Omera Naseer, revealed that a study conducted by her in 11 tertiary care hospitals found that 91% of patients were prescribed antibiotics, many unnecessarily. She maintained that most hospitals lacked antibiotic guidelines and did not conduct lab cultures for accurate prescriptions, leading to drug-resistant pathogens. “We are working with these hospitals and others to promote antimicrobial stewardship and rational use of antibiotics,” she stated.

The economic burden of AMR was highlighted by NIH’s senior pharmacist and AMR specialist, Numrah Safdar. She shared findings from studies at the Holy Family Hospital in Rawalpindi and the PIMS Islamabad, which showed that AMR significantly increased treatment costs and prolonged hospital stays.

NIH Microbiologist Zurva Ashraf presented alarming data on resistance in pathogens like E. coli, a leading cause of UTIs and sepsis, and Staphylococcus aureus, which caused MRSA infections. She said resistant strains of Klebsiella pneumoniae and pseudomonas aeruginosa were also leading to hard-to-treat infections in immunocompromised patients. Meanwhile, multidrug-resistant Salmonella Typhi continues to cause severe complications such as intestinal perforation.

The symposium was also addressed by experts including Dr Qadeer Ahsan from the Fleming Fund, Dr Naveed from the WHO, and Dr Shaheer Illahi from the HSA.

A panel discussion featuring Dr Munazza, Muhammad Akram, and Dr Hifza Rasheed further emphasized the urgent need for stewardship programs and collaboration among healthcare, agriculture, and environmental sectors to address the growing threat of AMR.