India emerges as epicentre of alarming superbug surge, antibiotic resistance crisis: Lancet study

Conducted with researchers from AIG Hospitals, the study places India at the centre of a rapidly worsening superbug surge and urges immediate policy intervention along with a nationwide push for responsible antibiotic use.

The findings were released to coincide with Antimicrobial Stewardship Week (November 18–25) to draw attention to the urgent need for rational antibiotic practices to become a national public-health priority.

The multicountry research—covering more than 1,200 patients across four nations—revealed that Indian patients undergoing a routine endoscopic procedure (ERCP) had the highest prevalence of MDROs among all participants.

While 83 percent of Indian patients carried MDROs, the rate was far lower elsewhere: 31.5 percent in Italy, 20.1 percent in the United States, and 10.8 percent in the Netherlands.

The bacteria identified in India included 70.2 percent with ESBL-producing organisms—which render many commonly used antibiotics ineffective—and a striking 23.5 percent harbouring carbapenem-resistant bacteria, resistant even to last-line drugs.

The study notes that these numbers cannot be explained by patient history or prior illnesses alone, even after accounting for age and comorbidities.

D. Nageshwar Reddy, Chairman of AIG Hospitals and a co-author of the research, stressed the gravity of the crisis.

“When more than 80 percent of patients are already carrying drug-resistant bacteria, the problem is clearly far beyond hospital boundaries. It is embedded in our communities, our environment, and our everyday lives,” he said.

Researchers point to a widespread community-driven problem fuelled by antibiotic misuse, over-the-counter access without prescriptions, incomplete medication courses, and rampant self-medication.

The presence of MDROs forces doctors to rely on more toxic, costly, and intensive treatments, prolonging recovery times and raising the risk of complications.

Dr Reddy cited a telling comparison: a patient with a severe infection but no drug-resistant bacteria recovered swiftly with basic antibiotics, left the hospital in three days, and spent around Rs 70,000.

A patient with the same condition but carrying MDR bacteria did not respond to first-line drugs, required powerful antibiotics, developed sepsis, needed ICU care, stayed over two weeks, and ultimately incurred expenses of Rs 4–5 lakh.

In a country where around 58,000 newborns die each year from drug-resistant infections, and where ICUs and cancer wards frequently encounter bacteria resistant to almost all available drugs, the study’s authors say the evidence is clear: antimicrobial resistance (AMR) is now a national health emergency.

The team urges policymakers, regulators, and healthcare institutions to treat the findings as a definitive call to action, not just another cautionary note.

They recommend urgent steps including: enforcing prescription-only rules for antibiotics, implementing nationwide antibiotic stewardship programmes, digitally tracking antibiotic use, tightening pharmacy oversight, and launching large-scale public-awareness campaigns.

They also call for a comprehensive One Health strategy to curb antibiotic overuse across human medicine, livestock, agriculture, and sanitation systems.

Dr Reddy outlined seven practices the public must adopt to slow the spread of resistance:

1. Never use antibiotics without a doctor’s prescription.

2. Avoid self-medication and leftover medicines.

3. Don’t push for antibiotics for viral illnesses like colds, fevers, or coughs.

4. Always finish the full antibiotic course.

5. Maintain strong hygiene: handwashing, clean water, safe food handling.

6. Keep all vaccinations up to date.

7. Use antibiotics in pets and livestock only under veterinary guidance.

Without swift intervention, the authors warn, India risks slipping into a post-antibiotic era where routine infections and common medical procedures become dangerous once again.

The study, they say, should serve as an urgent wake-up call before the crisis reaches an irreversible tipping point.