Pakistan is grappling with a growing crisis of antibiotic resistance, driven by the irrational use of third- and fourth-line antibiotics, particularly in hospitals. Experts cautioned on Wednesday that this silent pandemic is leading to untreatable infections, prolonged hospitalizations, rising treatment costs, and increased mortality rates. 

While no official data exists on the number of deaths caused by antibiotic resistance, thousands of lives are believed to be lost annually due to drug-resistant pathogens. Recognizing the urgency, experts called for a coordinated, multisectoral approach to combat the escalating threat. 

Speaking at the National Symposium on Antimicrobial Resistance (AMR), held as part of World Antimicrobial Awareness Week 2024 (WAAW), Dr. Muhammad Salman, Executive Director of the National Institute of Health (NIH), highlighted the severe burden of AMR in Pakistan. “The rise of extensively drug-resistant (XDR) infections, both in communities and hospital settings, poses a grave challenge to effective treatment,” he stated. 

The symposium, organized by the NIH in collaboration with the WHO, Fleming Fund, Health Services Academy (HSA), and Getz Pharma, featured discussions on combating AMR. Dr. Salman underscored the NIH’s commitment to addressing AMR through regular awareness campaigns, training sessions, and advocacy for the rational use of antibiotics. 

Dr. Atiya Abro, Deputy Director of Programs at the Ministry of National Health Services, emphasized that AMR not only threatens human health but also jeopardizes food security by impacting livestock and crops. She warned of environmental contamination due to resistant pathogens, which spread resistance genes and reduce agricultural productivity. The launch of Pakistan’s National Action Plan 2.0 reflects a firm commitment to rationalizing antibiotic use and promoting public awareness. 

Jaffer Bin Baqar, Public Health Lead at Getz Pharma, revealed that over 15,000 healthcare providers nationwide are being trained to discourage self-medication and the misuse of antibiotics. He stressed the importance of limiting antibiotic use to prescription-only practices and ensuring adherence to prescribed dosages. 

Senior NIH scientist and AMR lead, Dr. Omera Naseer, revealed alarming findings from her study across 11 tertiary care hospitals. “Ninety-one percent of patients were prescribed antibiotics, many unnecessarily. Most hospitals lack antibiotic guidelines or fail to conduct lab cultures for accurate prescriptions, exacerbating resistance,” she stated, adding that antimicrobial stewardship programs are being implemented to curb misuse. 

NIH pharmacist and AMR specialist, Numrah Safdar, highlighted the economic impact of AMR. Studies conducted at Holy Family Hospital in Rawalpindi and PIMS Islamabad showed significant increases in treatment costs and hospital stay durations due to resistant infections. 

NIH microbiologist Zurva Ashraf presented concerning data on resistant strains of E. coli, Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa, which are causing hard-to-treat infections in vulnerable patients. Additionally, multidrug-resistant Salmonella Typhi continues to cause severe complications, including intestinal perforation. 

Experts, including representatives from the Fleming Fund, WHO, and HSA, emphasized the urgent need for stewardship programs and cross-sector collaboration among healthcare, agriculture, and environmental sectors to address this crisis. A panel discussion with healthcare leaders further stressed the critical role of awareness and policy in combating AMR.