NEW DELHI: Some of the most common infections – urinary tract, pneumonia, sepsis and diarrhoeal illnesses – are becoming increasingly harder to treat in India as widely used antibiotics continue to fail at alarming rates.
ICMR’s annual report 2024 ‘Antimicrobial Resistance Research & Surveillance Network (AMRSN)’, showed that routine drugs like fluoroquinolones, third-generation cephalosporins, carbapenems and piperacillin-tazobactam are rapidly losing effectiveness against bacteria most frequently seen in hospitals.
Based on nearly one lakh lab-confirmed infection samples from leading hospitals, the report showed drug-resistant Gram-negative bacteria continue to dominate. E coli, the most common cause of UTIs and abdominal and bloodstream infections, showed declining susceptibility to strong antibiotics. Klebsiella pneumoniae, a major cause of pneumonia and sepsis, is resistant to piperacillin-tazobactam in nearly three-fourths of the cases and to carbapenems in most samples, limiting treatment options.
In ICUs, the situation is even more alarming. Acinetobacter baumannii shows 91% resistance to meropenem, forcing doctors to use more toxic or complicated drug combinations.
Pseudomonas aeruginosa continues to show rising resistance. Overall, 72% of bloodstream infections were caused by drug-resistant Gram-negative bacteria, while ventilator-associated pneumonia was driven largely by acinetobacter, klebsiella and pseudomonas – organisms against which many commonly prescribed high-end antibiotics are ineffective.
Though some isolated improvements were seen – including better sensitivity of E coli to amikacin and select cephalosporins – the broader resistance landscape continues to worsen. Diarrhoeal pathogens showed high resistance to fluoroquinolones and cephalosporins, and more than 95% of salmonella yyphi samples were resistant to fluoroquinolones. Among fungi, candida auris showed resistance in nearly 10% of isolates, while one-third of aspergillus samples were resistant to amphotericin B.
ICMR said the data reflects hospital infections, not community patterns. But experts warn the message is unmistakable: India’s most widely used antibiotics are losing power, and critically ill patients are already facing the consequences. Without aggressive stewardship and rational prescribing, they caution, even common infections may soon become untreatable.
Dr Rommel Tickoo, director, internal medicine, Max Hospital, Saket, said the findings mark a dangerous shift. “Strong antibiotics are failing against infections once treated easily. This signals an urgent public-health challenge that demands tighter control on antibiotic use and stronger infection-prevention measures.”
Data shows how quickly options are shrinking. “Everyday bacteria are resisting medicines we once relied on. In ICUs, choices are narrowing even further. Rational antibiotic use is no longer optional – it’s essential to preserve what still works,” Dr Rakesh Gupta, senior consultant, internal medicine, Indraprastha Apollo Hospitals, said.
