Pakistan is facing a growing public health crisis as the incomplete and unnecessary use of antibiotics continues to fuel antimicrobial resistance (AMR), placing millions of lives at risk and straining the country’s healthcare system.
Medical experts warn that between 200,000 and 300,000 people die every year in Pakistan either directly or indirectly due to infections caused by drug-resistant microorganisms. The situation is particularly alarming in intensive care units (ICUs), where a rising number of patients are suffering from infections caused by multi-drug resistant (MDR) bacteria.
According to the World Health Organization (WHO), antimicrobial resistance occurs when bacteria, viruses, fungi, or parasites evolve over time and become resistant to medicines, making infections increasingly difficult — and sometimes impossible — to treat.
Professor Dr Saeed Khan, Head of the Molecular Pathology Laboratory at Dow University of Health Sciences, told Express News that AMR is a global health threat that leads to prolonged illness, higher medical costs, treatment complications, and increased mortality.
“If the current trend continues, WHO estimates that antimicrobial resistance could cause up to 10 million deaths annually worldwide by 2050,” Dr Khan warned.
Pakistan Among High-Risk Countries
Experts say Pakistan is among the countries most vulnerable to AMR due to several contributing factors. These include the widespread availability of antibiotics without prescriptions, incomplete treatment courses, unnecessary antibiotic use, poor infection control in hospitals, excessive use of antibiotics in livestock and poultry, and weak surveillance and reporting systems.
Dr Khan highlighted that the most resistant bacteria found in major hospitals across Karachi include Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Methicillin-resistant Staphylococcus aureus (MRSA), and extensively drug-resistant (XDR) Salmonella Typhi.
These pathogens are increasingly responsible for urinary tract infections, ICU-related infections, typhoid fever, and bacterial pneumonia, which has become more lethal following influenza outbreaks due to the failure of first-line antibiotics.
Children, elderly patients, and individuals with weakened immune systems are at the highest risk.
ICUs and TB Wards Under Severe Pressure
Karachi’s hospital ICUs, neonatal units, surgical wards, tuberculosis units, and infection wards are now grappling with widespread MDR gram-negative infections and XDR typhoid, creating serious challenges for healthcare providers.
Dr Khan also pointed out that Pakistan carries one of the highest tuberculosis burdens globally, with multi-drug resistant (MDR) and extensively drug-resistant (XDR) TB emerging as national health emergencies. Treating these patients requires 18 to 24 months of prolonged and costly therapy, with significantly higher risks of treatment failure and death.
Studies suggest that 40 to 70 percent of ICU patients in major public and private hospitals in Pakistan suffer from infections caused by MDR organisms — primarily gram-negative bacteria — making treatment far more complex and expensive.
Rising Death Toll
Microbiologist Dr Syeda Sadaf Akbar stated that Pakistan ranks 29th among 204 countries in antimicrobial resistance severity. She added that data indicates 200,000 to 300,000 deaths annually in the country are linked to AMR, with resistance rates increasing by 5 to 15 percent each year globally.
Health professionals stress that urgent action is needed, including stricter regulation of antibiotic sales, improved infection control practices, public awareness campaigns, and stronger surveillance systems to prevent a looming healthcare catastrophe.
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