Some of India’s most common infections—urinary tract infections, pneumonia, sepsis, and diarrhoeal illnesses—are becoming increasingly difficult to treat as widely used antibiotics continue to fail at alarming rates. The ICMR Annual Report 2024 from the Antimicrobial Resistance Research & Surveillance Network (AMRSN) reveals that routine drugs such as fluoroquinolones, third-generation cephalosporins, carbapenems, and piperacillin-tazobactam are rapidly losing their effectiveness against hospital-acquired bacterial infections.
Drug-Resistant Gram-Negative Bacteria on the Rise
Drawing from nearly one lakh lab-confirmed infection samples across major hospitals, the report shows that drug-resistant Gram-negative bacteria still dominate the landscape.
E. coli—responsible for most UTIs and many abdominal and bloodstream infections—continues to show declining susceptibility to key antibiotics. Meanwhile, Klebsiella pneumoniae, a major cause of pneumonia and sepsis, is resistant to piperacillin-tazobactam in almost 75% of cases and to carbapenems in most samples, leaving very limited treatment choices.
ICUs Face Severe Treatment Challenges
In intensive care units, the scenario is even more concerning.
Acinetobacter baumannii shows 91% resistance to meropenem, forcing clinicians to rely on more toxic or complex drug combinations. Pseudomonas aeruginosa also shows steadily rising resistance rates. Overall, 72% of bloodstream infections stem from drug-resistant Gram-negative bacteria. Ventilator-associated pneumonia continues to be driven largely by acinetobacter, klebsiella, and pseudomonas—organisms against which many high-end antibiotics have little effect.
Widespread Resistance Beyond ICU Settings
Although a few isolated improvements were observed—such as better E. coli sensitivity to amikacin and some cephalosporins—the broader resistance trend remains deeply worrying.
Diarrhoeal pathogens show high resistance to fluoroquinolones and cephalosporins. More than 95% of Salmonella typhi isolates are resistant to fluoroquinolones. Fungal pathogens are also becoming harder to treat, with Candida auris showing resistance in nearly 10% of samples and one-third of Aspergillus isolates demonstrating resistance to amphotericin B.
Experts Warn of Shrinking Treatment Options
As reported by TOI, ICMR clarified that the data reflects hospital infections rather than community patterns. However, experts warn that the message is unmistakable: India’s most commonly used antibiotics are losing their power, and critically ill patients are already experiencing the consequences.
Dr. Rommel Tickoo, Director of Internal Medicine at Max Hospital, Saket, called the findings a dangerous turning point.
“Strong antibiotics are failing against infections that were once easily treated. This signals an urgent public-health challenge that requires tighter antibiotic control and stronger infection-prevention measures,” he said.
Urgent Need for Stewardship and Rational Use
Highlighting the rapidly shrinking treatment options, Dr. Rakesh Gupta, Senior Consultant, Internal Medicine, Indraprastha Apollo Hospitals, added,
“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.”