A Silent Pandemic of Antimicrobial Resistance: Challenges and Strategy for Preparedness in India

In the face of growing resistance against existing antibiotics and a dried-up pipeline of newer agents, theworld is heading towardasilent pandemic. Globally, an estimated 4.95 million deaths occurred in 2019 due to drug-resistant infections including 1.27 million deaths attributable directly to bacterial antimicrobial resistance (AMR). 1 As per projected esti-mates, by 2050, AMR would cause approximately 10 million deaths worldwide and 2 million deaths in India. 1,2 Recently (2019), in World Health Organization ’ s (WHO) list of 10 threats to global health, AMR stands on fi fth place. 3 In the preantibiotic era, infectious diseases were the primary cause of mortality worldwide. Today, if AMR left unchecked, treatable infections will lead to huge increases in fatality from bacterial infections worldwide. The resistance to fi rst line of empirical therapy ( β -lactam antibiotics and fl uroquino-lones) against six priority pathogens ( Escherichia coli , Staphylococcus aureus , Klebsiella pneumoniae , Streptococcus pneumoniae , Acinetobacter baumannii , and Pseudomonas. aeruginosa ) accounted for more than 70% deaths globally. 1 This continued escalation puts at risk the very practice of modern medicine, unless drastic measures are taken today to counter this threat.