According to the analysis, India had the highest proportion of multidrug-resistant organisms among participating countries at 83%, compared to 31% in Italy, 20% in the US and 10% in the Netherlands. | Photo credit: Representative photo
An international study has revealed an alarming prevalence of antimicrobial resistance (AMR) among patients in India, raising concerns about the country’s preparedness to deal with infections that no longer respond to standard antibiotics.
Presenting the findings, AIG Hospitals Chairman D. Nageshwar Reddy described the situation as one of the most dangerous threats to public health and called for urgent changes in regulation and behavior to avoid a return to the pre-antibiotic era.
The study, titled “Preprocedural screening for multidrug-resistant organisms in endoscopic retrograde cholangiopancreatography,” published in The Lancet’s eClinicalMedicine, was conducted in India, the Netherlands, Italy, and the United States. It screened more than 1,200 patients undergoing ERCP procedures using rectal and nasal swabs to determine the presence of harmful bacteria resistant to multiple antibiotics. According to the analysis, India had the highest proportion of multidrug-resistant organisms among participating countries at 83%, compared to 31% in Italy, 20% in the US and 10% in the Netherlands.
Dr. Reddy explained that the human body normally hosts billions of bacteria, particularly in the nose, gut and skin, many of which are harmless or even beneficial. The problem arises when some strains develop resistance to antibiotics and transfer these resistance genes to other bacteria in the body. “This process turns the microbial ecosystem into a breeding ground for organisms capable of resisting even the strongest antibiotics,” he added.
The AIG team used advanced culture techniques and genetic analysis to identify bacteria such as Enterobacteriaceae and Pseudomonas, both classified as high-risk pathogens responsible for difficult-to-treat infections. The findings were cross-validated by laboratories in the Netherlands, Italy, the USA and the Czech Republic due to the unexpectedly high levels of resistance found in samples from India.
One of the most striking observations from the patient interviews was that not a single Indian patient admitted to taking antibiotics. Dr. Reddy said this reflects two serious problems. First, patients may not be aware that they have taken antibiotics because pharmacists routinely dispense them without a prescription, often without informing customers. Second, resistant bacteria enter the population through contaminated food sources such as milk, poultry, aquaculture products, agricultural products, and processed foods.
To solve the crisis, Dr. Reddy’s “triad of actions” based on strict regulation, responsible prescribing and public education. He argued that urgent action was needed to stop the over-the-counter sale of antibiotics, which continues despite regulatory restrictions under Schedule H and H1 of the Drugs and Cosmetics Rules. He suggested that India consider moving antibiotics to Schedule X, a category reserved for narcotics that requires strict monitoring and enforcement.
Dr. Reddy warned that within five years, India could reach a point where up to 95% of all organisms become resistant to available antibiotics, effectively taking the country back to the pre-penicillin era.
Published – 18 Nov 2025 19:53 IST
