Pakistan is facing a growing public health crisis due to unnecessary use or underdosing of antibiotics, with medical experts warning that antimicrobial resistance (AMR) is claiming between 200,000 and 300,000 lives in the country each year, either directly or indirectly.
Doctors say there has been a sharp increase in the number of critically ill patients whose infections are caused by multidrug-resistant organisms, particularly in ICUs. They warn that if current trends continue, antimicrobial resistance could become one of the leading causes of death.
According to the World Health Organization (WHO), AMR occurs when bacteria, viruses, fungi or parasites evolve over time and become resistant to medications, making standard treatments ineffective and infections increasingly difficult (and in some cases impossible) to treat.
“Antimicrobial resistance has become a global threat, prolonging the disease, significantly increasing treatment costs, increasing the risk of complications and leading to increased mortality,” said Professor Dr. Saeed Khan, head of the Laboratory of Molecular Pathology at Dow University of Health Sciences. The Express PAkGazette.
He warned that antimicrobial resistance is also undermining modern healthcare, posing serious risks to surgeries, chemotherapy and intensive care services. Citing WHO estimates, he said that if effective control measures are not implemented, antibiotic resistance could cause up to 10 million deaths annually worldwide by 2050.
Dr Khan said Pakistan is among countries at particularly high risk of AMR due to widespread use of over-the-counter antibiotics, incomplete or unnecessary medication, poor infection control practices in hospitals, overuse of antibiotics in livestock and poultry, and weak surveillance and reporting systems.
He added that the most commonly identified drug-resistant bacteria in major hospitals in Karachi include Escherichia coli, Klebsiella pneumonia, Acinetobacter baumannii, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA) and extensively drug-resistant (XDR) Salmonella typhi. These pathogens pose serious risks in urinary tract infections, UTIs, and diseases such as typhoid fever.
Dr Khan added that bacterial pneumonia after the flu has become more lethal as first-line antibiotics are often ineffective, leading to delays in proper treatment and more severe illness. Children, the elderly, and immunocompromised people are particularly vulnerable to drug-resistant infections.
He further said that multidrug-resistant gram-negative infections and XDR typhoid have emerged as major challenges in city hospitals, especially ICUs, neonatal wards, surgery wards, tuberculosis wards and infectious disease units.
Dr Khan said Pakistan continues to be among the countries with the highest number of tuberculosis cases, while multidrug-resistant (MDR) and XDR tuberculosis have reached alarming levels. These patients require prolonged and expensive treatment lasting 18 to 24 months and face increased risks of treatment failure and death.
According to various studies, he said, between 40 and 70 percent of patients admitted to the ICUs of the country’s main public and private hospitals suffer from infections caused by multi-resistant organisms, mostly gram-negative bacteria, which makes treatment increasingly complex.
Meanwhile, microbiologist Dr Syeda Sadaf Akbar said that Pakistan ranks 29th among 204 countries in terms of antibiotic resistance. He said available data indicates that between 200,000 and 300,000 people die each year in Pakistan due to antimicrobial resistance, either directly or indirectly, and warned that the rate of resistance continues to rise annually, with global data showing an increase of 5 to 15 percent.
