Pakistan faces a growing public health crisis due to unnecessary use or incomplete doses of antibiotics, with medical experts warning that antimicrobial resistance (AMR) claims between 200,000 and 300,000 lives in the country every year – directly or indirectly.
Doctors say there has been a sharp increase in the number of seriously ill patients whose infections are caused by multidrug-resistant organisms, particularly in intensive care units. They warn that if current trends continue, AMR 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 drugs, rendering standard treatments ineffective and making infections increasingly difficult, if not impossible, to treat.
“AMR has become a global threat because it prolongs the disease, significantly increases treatment costs, increases the risk of complications and leads to higher mortality,” said Professor Dr Saeed Khan, Head of the Molecular Pathology Laboratory at Dow University of Health Sciences. The Express PK Press Club.
He warned that AMR also undermines modern medical care, posing serious risks to surgery, chemotherapy and intensive care wards. Citing WHO estimates, he said that if effective control measures are not implemented, antibiotic resistance could cause up to 10 million deaths per year globally 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 medicines, poor infection control practices in hospitals, excessive use of antibiotics in livestock and poultry, and weak monitoring and reporting systems.
He added that the most drug-resistant bacteria commonly identified in major hospitals in Karachi include Escherichia coli, Klebsiella pneumonia, Acinetobacter baumannii, Pseudomonas aeruginosa, Methicillin-resistant Staphylococcus aureus (MRSA) and Extensively drug-resistant Salmonella typhi (XDR). These pathogens pose serious risks in urinary tract infections, intensive care, and diseases such as typhoid.
Dr Khan added that bacterial pneumonia following influenza has become more deadly because first-line antibiotics are often ineffective, leading to delays in appropriate treatment and more severe illness. Children, the elderly, and immunocompromised individuals are particularly vulnerable to drug-resistant infections.
He added that multidrug-resistant Gram-negative infections and XDR typhoid have become major challenges in the city’s hospitals, especially in intensive care units, neonatal wards, surgery wards, tuberculosis wards and infectious disease units.
Dr Khan said Pakistan remains among the countries with the highest number of TB cases, while multidrug-resistant (MDR) TB and XDR TB have reached alarming levels. These patients require prolonged and expensive treatment, lasting 18 to 24 months, and face higher risks of treatment failure and death.
According to various studies, he said, between 40 and 70 percent of patients admitted to intensive care units of the country’s main public and private hospitals suffer from infections caused by multidrug-resistant organisms, mostly Gram-negative bacteria, making treatment increasingly complex.
Meanwhile, microbiologist Dr Syeda Sadaf Akbar said that Pakistan ranks 29th out of 204 countries in terms of antibiotic resistance. She said available data indicates that 200,000 to 300,000 people die every year in Pakistan due to AMR, either directly or indirectly, and warned that the rate of resistance continues to rise every year, with global data showing an increase of 5 to 15 percent.
