Pakistan faces a growing public health crisis due to the 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 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 intensive care units. They warn that if the current trend continues, AMR could emerge as one of the leading causes of death.
According to the World Health Organization (WHO), AMR occurs when bacteria, viruses, fungi or parasites develop over time and become resistant to drugs, rendering standard treatments ineffective and making infections increasingly difficult – and in some cases impossible – to treat.
“AMR has become a global threat as it prolongs 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, Express Pakinomist.
He warned that AMR is also undermining modern medical care, posing a serious risk to surgeries, chemotherapy and critical care. 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 the countries at particularly high risk of AMR due to the widespread use of antibiotics without a prescription, incomplete or unnecessary medication, poor infection control 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 highly drug-resistant Salmonella typhi (XDR). These pathogens pose a serious risk in urinary tract infections, intensive care units and diseases such as typhus.
Dr. Khan added that post-influenza bacterial pneumonia has become more deadly as first-line antibiotics are often ineffective, resulting in delays in appropriate treatment and more severe disease. 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 the city’s hospitals, especially in intensive care units, neonatal units, surgical units, tuberculosis units and infectious disease units.
Dr. Khan said Pakistan remains among the countries with the highest number of TB cases, while multidrug-resistant (MDR) and XDR TB have reached alarming levels. Such patients require prolonged and expensive treatment lasting 18 to 24 months and face a higher risk of treatment failure and death.
According to various studies, he said, between 40 and 70 percent of patients admitted to intensive care units in major public and private hospitals across the country suffer from infections caused by multidrug-resistant organisms, most of them gram-negative bacteria, making treatment increasingly complex.
Meanwhile, microbiologist Dr. Syeda Sadaf Akbar that Pakistan ranks 29th among 204 countries in terms of antibiotic resistance. She said available data indicates that 200,000 to 300,000 people die each year in Pakistan due to AMR, either directly or indirectly, and warned that the rate of resistance continues to rise annually, with global data showing a 5 to 15 percent increase.
