When antibiotics fail: Why common infections are turning fatal | Second Opinion

A recent report from the Indian Council of Medical Research (ICMR) shows alarming resistance levels among common bacteria in India — with treatments for urinary, gastrointestinal, and other routine infections failing more often than not. Antibiotics once considered reliable are losing effectiveness, leaving patients vulnerable and hospitals overburdened.

According to the ICMR 2024 Antimicrobial Resistance Surveillance Network report, bacteria such as Escherichia coli (E. coli) and Klebsiella pneumoniae now show 70 to 85 per cent resistance to commonly prescribed antibiotics. Many first-line drugs — including fluoroquinolones and third-generation cephalosporins — often fail. Even carbapenems, considered the last-line defence, are now ineffective in a growing number of cases.

High resistance levels

E. coli — a frequent culprit in urinary tract infections and bloodstream infections — now shows 57 per cent resistance to carbapenems. Meanwhile, diarrhoea- and typhoid-causing bacteria display a shocking 95 per cent resistance to fluoroquinolones. Klebsiella’s resistance to piperacillin-tazobactam and carbapenems reaches 75 per cent, while resistance to the latter climbs to 40 to 75 per cent in serious cases.

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Pneumonia-causing Acinetobacter baumannii is alarmingly 90 per cent resistant to meropenem, a powerful antibiotic. With such resistance, even minor infections risk turning fatal, especially in overburdened hospitals.

Overuse fuels the crisis

Experts link the crisis to rampant over-the-counter antibiotic use, self-medication, and over-prescription. Easy access to antibiotics without prescriptions allows people to treat viral colds, minor cuts or basic infections with powerful drugs accelerating resistance.

Dr Subramanian Swaminathan, Director of Infectious Diseases, warns: “Antimicrobial resistance is becoming a major challenge... A lot of drugs we once took for granted are no longer effective … The number of drugs available to treat simple infections is becoming less.”

He added that treatment options are becoming expensive, side-effects more common, and complications increasingly likely.

Impact on children and clinical care

Paediatric care is also under threat. Dr Vaishanavi Chandramohan, a consultant paediatrician, said urinary and genital infections in children previously treated with ceftirizone are now often resistant. In 60–70 per cent of cases involving E. coli, ceftirizone no longer works, forcing doctors to resort to stronger, more expensive antibiotics — often with greater side-effects and longer hospital stays.

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The collapse of first-line treatments means children risk longer illnesses, higher costs, and increased odds of complications.

Call for urgent action

Microbiologists and clinicians are calling for stricter regulations on antibiotic sales and prescribing practices. Dr Bhavini Shah, head of microbiology at a diagnostic lab, said: “AMR is everywhere. Clinicians are at a loose end. There are millions dying because of resistance. There is no drug to give a patient who gets into sepsis.”

She emphasised the need for a team approach between government and private sectors combining reliable diagnostics, regulation of over-the-counter sales, and public awareness.

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Doctors underscore that simple precautions can help: always complete the full course of antibiotics if prescribed; avoid self-medication; demand proper diagnosis before drugs. As Dr Swaminathan said — many common fevers in communities (like flu, dengue, or chickenpox) are viral and do not need antibiotics.

Implications for healthcare system

If resistance trends continue, India may see a surge in hospitalisations for what were once manageable infections. Healthcare costs will rise, hospital capacities will be stretched, and mortality could increase sharply — even for routine illnesses. Without stricter controls, better diagnostics, and public discipline, the “super-bug” threat may undo decades of medical progress.

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