Antibiotics misuse may fuel drug-resistant ‘superbugs’, warn experts

KARACHI: The widespread misuse of antibiotics in Pakistan poses threat of drug-resistant "superbugs" — infections that no longer respond to standard treatments, health experts and officials from the Drug Regulatory Authority of Pakistan (DRAP) and the National Institute of Health (NIH) warned.

Speaking at an awareness session on Antimicrobial Resistance (AMR) recently held in Karachi, specialists termed AMR a "silent pandemic" and one of Pakistan's most critical healthcare challenges, already contributing to hundreds of thousands of deaths annually.

Shaukat Khanum Memorial Hospital Lahore CEO Dr Faisal Sultan, also an infectious disease specialist, urged federal and provincial governments to enforce strict regulations, ensuring that antibiotics are only sold with a prescription.

He also proposed the introduction of a Unified Prescription App to regulate antibiotic sales nationwide.

“Antibiotics revolutionised healthcare, making advanced surgeries and treatments possible. However, their overuse is now leading to a crisis where even routine infections, such as typhoid, are becoming untreatable,” Dr. Sultan warned.

Antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites evolve to withstand medications intended to kill them, making infections more difficult to treat. In Pakistan, rampant overprescription, self-medication, and weak regulation have driven a surge in drug-resistant infections, resulting in longer hospital stays, higher treatment costs, and increased mortality rates.

DRAP CEO Asim Rauf regretted that while guidelines mandate antibiotics be sold only by prescription, enforcement remains weak at the provincial level.

“Medicine regulation is a provincial responsibility, and it’s imperative that provincial governments treat this issue with urgency,” Rauf said. He also underscored the critical role the media can play in raising awareness about AMR, referencing The Lancet's report estimating that AMR accounts for around 1.27 million global deaths annually, with Pakistan following a similar path.

Rauf further indicated that DRAP is preparing to take action against unethical pharmaceutical marketing practices that encourage the overuse of antibiotics. “Regulators will tighten enforcement, but the media must also amplify the message about the dangers of AMR,” he added.

NIH Islamabad CEO Dr. Muhammad Salman presented data from a survey of 11 major hospitals, revealing that 92pc of hospitalised patients were prescribed antibiotics, signalling extensive overuse.

He shared that NIH is working on the second phase of the National Action Plan for AMR, expected to be completed by the end of the year, and called for stronger government and donor support for its implementation.

“There is a severe lack of awareness about AMR in Pakistan, even among healthcare professionals,” Dr. Salman said, stressing the need for educational campaigns to close this gap.

Dr. Obaidullah, Director of Quality Assurance at DRAP, noted that over 3,000 metric tons of raw antibiotic materials were imported into Pakistan in 2019, expressing concerns about the unregulated use of antibiotics in the poultry industry, which he said contributes to the rise of drug-resistant bacteria in humans.

“Stricter oversight is required, not just in healthcare but also in sectors like agriculture, where unchecked use of antibiotics is a growing concern,” he stated.

Zeeshan Ahmed, Chief Operating Officer of Getz Pharma, called for stronger collaboration between the pharmaceutical industry, regulators, and healthcare providers to combat AMR. He also emphasised the role of community pharmacists in curbing self-medication, which is rendering many antibiotics ineffective.

“Media must highlight the dangers of self-medication. Community pharmacists at drug stores should be incentivised to ensure that antibiotics are sold only with a proper prescription,” Ahmed suggested.

The session evolved a consensus that Pakistan must act swiftly to enforce regulations, enhance public awareness, and improve coordination between federal and provincial authorities.

Failure to take these measures could lead to a healthcare crisis marked by untreatable infections, rising healthcare costs, and preventable deaths, the experts warned.