Antibiotics are losing their effectiveness. Antibiotics are now not working in 41 per cent of patients in hospital intensive care units. The irrational and excessive use of antibiotics is deepening this crisis day by day.
The state-run Institute of Epidemiology, Disease Control and Research (IEDCR) presented this observation today, Monday, at an event held in Mohakhali, Dhaka. The report was presented by professor Zakir Hossain, the institution’s Chief Scientific Officer.
Issuing warning against the excessive use of antibiotics, professor Zakir Hossain said that indiscriminate use has pushed antimicrobial resistance (AMR) to a dangerous level. This has now become a major public health threat in Bangladesh.
He urged everyone to use antibiotics responsibly to protect their own lives.
To assess antibiotic effectiveness, IEDCR examined samples from 96,477 patients between July 2024 and June this year. They tested the performance of 71 different antibiotics on ICU patients at five hospitals.
For ICU patients, the effectiveness of 71 antibiotics was evaluated against five key pathogens. Of these, five antibiotics showed above 80 per cent sensitivity, one showed sensitivity between 60–80 per cent and the rest were below 60 per cent.
Among all samples tested, 7 per cent of patients had microbes classified as pan-drug-resistant (PDR) — meaning none of the antibiotics for that infection worked. In ICU patients, the presence of PDR organisms was 41 per cent, meaning almost half of ICU patients did not respond to any available drugs.
IEDCR noted that since 2016 it has been implementing the National Antimicrobial Resistance (AMR) Surveillance programme. The goal is to establish a strong monitoring system to track AMR trends among key pathogens significant to public health.
The institute analysed 123 drug–bug combinations in its latest observation. Comparing results with previous years: effectiveness increased in 38 combinations, decreased in 79, and remained unchanged in six.
IEDCR director professor Tahmina Shirin said the institute has been working on antibiotic resistance since 2017 and has already developed a large national database.
She said, “We want to convey this appeal to the public so that people do not take antibiotics without the advice of specialist doctors. If public awareness does not increase, a serious crisis will arise in the future.”
Highest antibiotic use in Dhaka
According to IEDCR, 57 per cent of all antibiotics used nationwide from July 2024 to June this year were used in Dhaka. Experts say this is because Dhaka has the highest number of patients, more specialised medical centres, and greater access to healthcare services.
After Dhaka, the highest usage was recorded in Rajshahi, Chattogram, Khulna, Barishal, Rangpur, and Sylhet. The report also noted that antibiotics are used more frequently among patients with urinary tract infections (UTIs).
The 10 most commonly used antibiotics in Bangladesh were: Ceftriaxone, Cefixime, Meropenem, Ciprofloxacin, Azithromycin, Amoxicillin, Metronidazole, Cloxacillin, Piperacillin–Tazobactam, and Vancomycin. Experts believe their excessive and unnecessary use is rapidly reducing their effectiveness.
Experts stressed the urgency of implementing effective policies to tackle AMR. They called for a national antibiotic use policy and widespread public awareness. People must not be allowed to purchase antibiotics from pharmacies without a doctor’s prescription. Otherwise, within the next decade, the healthcare system will face a major crisis. They emphasised: the less antibiotics are used, the more effective they remain.
Higher antibiotic effectiveness among Rohingyas
IEDCR found that antibiotic effectiveness is comparatively higher among the Rohingya refugees in Cox’s Bazar camps. The reason, according to IEDCR, is that people there generally take medicines following a doctor’s advice.
Among the Rohingyas, tetracycline showed 100 per cent effectiveness – every patient responded to the drug. Azithromycin was effective in 97 out of every 100 patients. This drug is used most frequently there to treat diarrheal diseases.