Superbugs surge in India: 83% of patients affected, says Lancet; simple illnesses could become life-threatening

Hyderabad: A new, major international study published in the prestigious Lancet eClinical Medicine journal reveals an alarming public health crisis in India, with 83 per cent of Indian patients carrying multidrug-resistant organisms (MDROs), also known as superbugs.

This is the highest prevalence reported among all participating countries. The Indian study was led by the Asian Institute of Gastroenterology (AIG) Hospitals in Hyderabad. The other three hospitals where the study was carried out were in the Netherlands, Italy and the United States of America.

Epicentre of a superbug explosion

Released during Antimicrobial Stewardship Week (Nov 18-25), the study warns that India is at the ‘epicentre of a superbug explosion,’ necessitating immediate policy changes.

There is an unprecedented crisis of Antimicrobial Resistance in the Indian population, and if this goes unchecked, it will make even minor infections untreatable in future, leading to a pandemic-type situation in the country, observed the researchers at AIG Hospitals, Hyderabad.

High levels of specific resistance

The international, multicentre study analysed over 1,200 patients across four countries undergoing a common endoscopic procedure (ERCP). The stark comparison in MDRO carriage rates underscores India's critical situation:

India: 83%

Italy: 31.5%

United States: 20.1%

Netherlands: 10.8%

Indian participants also showed exceptionally high levels of specific dangerous resistance, including 70.2 per cent with ESBL-producing organisms and 23.5 per cent with carbapenem-resistant bacteria, which are resistant even to last-resort antibiotics.

Beyond Hospitals: A national emergency

Dr D Nageshwar Reddy, chairman of AIG Hospitals and co-author of the study, stressed the urgency of the findings.

“When over 80 per cent of patients coming for a routine, commonly performed procedure are already carrying drug-resistant bacteria, it means the threat is no longer limited to hospitals, it is in our communities, our environment and our daily lives,” Dr Reddy stated.

The study suggests that this dramatically higher MDRO prevalence in India cannot be explained by medical history alone. It points to a deep-rooted community-level problem linked to:

- Antibiotic misuse

- Easy over-the-counter availability of antibiotics

- Incomplete treatment courses

- Widespread self-medication

58,000 newborn deaths linked to resistant infections

The authors warn that these points mark a ‘public health emergency’.

For India, where approximately 58,000 newborn deaths annually are linked to resistant infections, and where ICUs often face untreatable bacteria, the data confirms that Antimicrobial Resistance (AMR) is a national health emergency.

Impact on patients: Increased cost and suffering

Dr Hardik Rughwani, a gastroenterologist and co-investigator from AIG Hospitals, highlighted the direct consequences for patients. These organisms delay recovery, increase complications and significantly raise treatment costs.

Dr Reddy provided a real-life example: two patients with the same condition, acute cholangitis, had drastically different outcomes.

Non-MDR Patient: Stabilised within 28-48 hours with standard antibiotics, discharged in about 3 days. Total cost: approx. Rs 70,000.

MDR Patient: Failed first-line antibiotics, required escalation to high-end drugs and ICU care, and stayed for more than 15 days. Total cost: Rs 4-5 lakh.

“We are staring at a future where simple infections may become untreatable,” Dr Reddy warned.

Call for urgent national action

The study authors are calling for decisive national action to prevent a ‘true public health disaster’. Recommended reforms include:

- Strict prescription-only antibiotic policies

- Nationwide antibiotic stewardship programmes

- Digital tracking of antibiotic use

- Stronger pharmacy regulations

- Mass public-awareness campaigns

A comprehensive One Health approach, addressing misuse in humans, livestock, agriculture, and sanitation, is deemed essential to control the spread of resistant organisms.

Action points for the public

Dr Reddy also suggested six critical steps for the general public to follow diligently:

- Never take antibiotics without a doctor’s prescription: Avoid self-medication or incomplete courses.

- Don’t demand antibiotics for viral illnesses: Antibiotics are ineffective against most colds, coughs, and fevers.

- Always complete the full antibiotic course when prescribed.

- Maintain strong hygiene habits: Regular handwashing and safe food handling reduce the need for antibiotics.

- Keep vaccinations up to date to prevent infections.

- Handle pets and livestock responsibly: Do not use antibiotics in animals without veterinary advice, as resistance spreads between animals and humans.