Antibiotics have been in use for last seventy years for treatment of infectious diseases, which has saved countless lives. The world is now transitioning into a “post-antibiotic era” where common infections and minor injuries will become deadly once again, due to increasing “Anti-Microbial Resistance” (AMR) of microbes.


What is Anti-Microbial Resistance / AntiBiotic Resistance?

When a microsorganism stops being sensitive to an antimicobial medicine to which it was previously sensitive, it is known as Antimicrobial resistance (AMR).

Such resistant microorganisms (which include bacteria, viruses and also some parasites) are able to withstand the treatment by antimicrobial medicines like – antibiotics, antivirals, and anti-malarials. These resistant pathogens are commonly called superbugs. They render the available standard treatments ineffective leading to persistence of infections which may potentially spread to others.


Causes of AMR – How does Antimicrobial Resistance happen ?

Antibiotic resistance develops in a microorganism when it is exposed to antimicrobial medicines and it changes in a way that reduces the impact of the drug on the micobe. AMR develops when a microorganism mutates or acquires a resistance gene against the antimicrobial drug. In certain cases the resistance develops through the natural evolution of bacterial pathogens.

The rising consumption of antibiotics is a major contributor. The microbes can develop drug resistance when people take incorrect doses of antibiotics.

Resistant strains can then be contracted directly from animals, water, air or other people.


Effects of AMR – Why is Antomicrobial resistance a matter of global concern?

AMR is increasingly responsible for killing, hampering the control of infectious diseases. Life saving drugs are being rendered impotent due to Amtimicrobial Resistance.

It engenders the costs of health care due to lengthier treatments required in hospitals.

On a global level it threatens the ground covered in Millenium Development Goals and endangers the achievements of Sustainable Development Goals.

AMR poses severe challenges to medical procedures like organ transplants, major surgeries, etc. which rely in effective antimicrobials for success. This jeopardizes health-care gains to the whole society.


Factors responsible for increasing AMR

  • Weak public health system, creates poor infection control, aided by inadequate sanitary conditions give ideal environment for development of superbugs.
  • Excessive Prescription of antibiotics for a variety of diarrhoeal and respiratory infections despite their limited curative potential has exacerbated the situation.
  • Poor regulation of pharmacies.
  • Cheap antibiotics 
  • Self Medication : The lack of awareness among patients regarding the appropriate use of antibiotics has led to self-medication and non-adherence to the prescribed course of antibiotics, further intensifying the problem.
  • Misuse of antibiotics: They are given as growth promoters in animals and fishes.


2017 : WHO’s top 12 priority pathogens for new antibiotics

The World Health Organisation (WHO) has published its first ever list of antibiotic-resistant ‘priority pathogens’ — a catalogue of 12 families of bacteria that pose the greatest threat to human health.

Priority 1: Critical

  • Acinetobacter baumannii, carbapenem-resistant
  • Pseudomonas aeruginosa, carbapenem-resistant
  • Enterobacteriaceae, carbapenem-resistant, ESBL-producing

Priority 2: High

  • Enterococcus faecium, vancomycin-resistant
  • Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate resistant
  • Helicobacter pylori, clarithromycin-resistant
  • Campylobacter spp., fluoroquinolone-resistant
  • Salmonellae, fluoroquinolone-resistant
  • Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant

Priority 3: Medium

  • Streptococcus pneumoniae, penicillin-non-susceptible
  • Haemophilus influenzae, ampicillin-resistant
  • Shigella spp., fluoroquinolone-resistant

Unfortunately, India has most of these 12 superbugs present in the country. This list has been drawn up to promote research and development of new antibiotics.


It is estimated that the prevalence of Multi-Drug-Resistant Tuberculosis (MDR-TB) in India is 2-3% among the new pulmonary TB patients and around 15% for re-treatment pulmonary TB patients.

There is need for the global community to urgently address the indiscriminate use of antibiotics and also fast-track research on the next generation of drugs.

India will need a revamped healthcare system in place to provide optimum treatment to its population and manage the extensive risks posed by the superbugs.

Study Material for UPSC IAS Prelims and Mains