Expert warns of consequences of antimicrobial resistance in healthcare

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ISLAMABAD: Antimicrobial resistance (AMR) has widespread consequences, not only in healthcare but also in agriculture, animal husbandry and food production.

Overuse of antimicrobials in livestock, poultry, and aquaculture contributes significantly to the emergence of resistant strains. Contamination of food products such as meat and milk with drug-resistant bacteria poses a direct risk to human health.

This was stated by Prof Ejaz A. Khan, Department of Pediatrics and Infectious Diseases at Shifa International Hospital, in a statement in connection with World Antimicrobial Resistance Awareness Week (WAAW) from November 18–24.

“Antimicrobial resistance develops when bacteria, viruses, fungi, and parasites evolve to resist the effects of medications, rendering treatments ineffective. Overuse and misuse of antibiotics are leading contributors to this crisis. Declared one of the greatest threats to global health, AMR could potentially undo decades of medical advancements if not addressed promptly,” he said.

The theme for 2024, “Educate, Advocate and Act Now,” places a renewed focus on coordinated action against AMR. Scientists have warned that we are approaching a “post-antibiotic era” where once treatable infections become deadly due to the emergence of superbugs.” Alarmingly, an estimated 700,000 deaths worldwide occur each year due to AMR. By 2050, this number could escalate to 10 million deaths annually - exceeding deaths caused by cancer - unless urgent measures are taken.

The Covid-19 pandemic exacerbated inappropriate antibiotic use. During the period, both healthcare providers and the public frequently resorted to unnecessary use of broad-spectrum antibiotics, compounding the AMR crisis. Every inappropriate antibiotic prescription diminishes the drug’s efficacy, allowing resistant bacteria to thrive and multiply.

Prof Khan said Pakistan was the third largest consumer of antibiotics among low- to middle-income countries.

“Approximately 70–90pc of patients with viral upper respiratory tract infections (URTIs), which do not require antibiotics, prescribed them unnecessarily. This misuse has contributed to the rise of resistant infections and thousands of preventable deaths annually. Post-pandemic, the situation has worsened, threatening national and global efforts to combat AMR,” he said.

“Fortunately, many of the infections contributing to the AMR burden are vaccine-preventable. Vaccines have a dual benefit: they reduce the incidence of infectious diseases and minimise the need for antibiotic use, thereby curbing resistance. In countries with widespread vaccine coverage, the incidence of diseases like pneumonia, diarrhoea, otitis media and typhoid has significantly declined. In Pakistan, vaccines against rotavirus, typhoid, pneumococcal diseases, and measles are part of the National Expanded Programme on Immunisation (EPI). The introduction of Typhoid Conjugate Vaccines (TCVs) has been a game changer in reducing cases of multidrug-resistant Salmonella Typhi,” he said.

“Universal vaccine coverage has the potential to save countless lives. Research indicates that achieving global coverage of high-priority childhood vaccines could avert 181,500 deaths annually and prevent the spread of resistant infections. This makes expanding vaccine access a cornerstone of Pakistan’s National Action Plan for AMR,” he said.

He suggested that collaborative strategies should include public awareness campaigns, stronger infection control measures regulating antibiotic use and expanding vaccine coverage.

Published in Dawn, November 24th, 2024

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