CIDSCON 2025: Battling AMR with a Multi-Faceted Approach

At the 15th Annual Conference of the Clinical Infectious Diseases Society (CIDSCON 2025), medical experts strongly advocated for a comprehensive, multi-faceted strategy to tackle the escalating threat of Antimicrobial Resistance (AMR) in India. This pervasive health challenge demands immediate, coordinated action from various stakeholders. Many specialists, including Dr. Vasant Nagwekar, Secretary, CIDS, and Dr. George Varghese from CMC Vellore, highlighted critical areas for intervention. Dr. Kamini Walia, Senior Scientist at ICMR, served as the chief guest, underscoring the national importance of this discussion.

Inappropriate Antibiotic Use Fuels Resistance

Inappropriate antibiotic use significantly contributes to the growing problem of AMR. Dr. George Varghese, for instance, noted that “Most of the antibiotics prescribed are unnecessary, and that too for a long duration.” This widespread practice creates “antibiotic pressure,” thereby leading to increased resistance. Furthermore, judicious use of antibiotics can considerably impact resistance levels. India has a high rate of antibiotic consumption, partly due to poor prescription practices, self-medication, and over-the-counter sales.

Strengthening Stewardship and Infection Control

Implementing robust antibiotic stewardship programs and basic infection control practices is paramount. Dr. Rajeev Soman, Scientific Chairperson, CIDS, asserted that “AMR should be discussed in large and small hospitals through stewardship programs.” Moreover, simple measures like diligent handwashing remain crucial in preventing infection spread. Consequently, patients admitted to multi-specialty hospitals often present with pre-existing resistance, complicating treatment. India’s National Action Plan on AMR (NAP-AMR), launched in 2017, prioritizes awareness, surveillance, and optimizing antimicrobial use. The Indian Council of Medical Research (ICMR) actively supports antibiotic stewardship initiatives.

Addressing Rising Resistance Rates and Rational Use

Resistance rates are alarmingly high in India, necessitating rational antibiotic use. Dr. Vasant Nagwekar reported that “Around 60 per cent-70 per cent of resistance to third-generation sepsis occurs in India.” AMR poses a major concern for lower- and middle-income countries globally. Beyond bacterial infections, tropical diseases such as dengue, malaria, and leptospirosis are becoming increasingly difficult to treat. Thus, physicians must rationalize antibiotic use according to established protocols and guidelines, ensuring the right antibiotic for the correct organism to lower resistance. Studies show declining susceptibility to carbapenems for common pathogens like E. coli and Klebsiella pneumoniae in India.

Systemic Reforms and Education for Future Generations

Combating AMR requires systemic reforms and comprehensive education. Dr. Subramanian, VP, CIDS, emphasized that “This is a complicated problem of AMR that cannot be fixed with one intervention and needs a multi-faceted approach.” He further suggested that sanitation, rather than just antibiotics or vaccines, offers the most effective answer to reducing infection-related deaths. The Indian medical system requires upgrades, with the government integrating infection control into the medical curriculum. For instance, in Western countries, all medical professionals, regardless of specialty, learn basic infection control and antibiotic resistance principles. This ensures patient safety and protects healthcare providers.

Patient Safety and Hospital-Acquired Infections

Ensuring patient safety and mitigating the risk of hospital-acquired infections (HAIs) are vital. Dr. V. Balaji highlighted, “Safety of the patient is important in the hospital.” Patients admitted for conditions like diabetes might develop sepsis from HAIs, creating a “double burden.” Hospitals can unfortunately act as “incubators” for infections, facilitating their spread. HAIs account for approximately 2 million cases and 80,000 deaths annually in India, often due to overcrowded hospitals, poor infrastructure, and lack of hygiene. India faces a significant burden of hospital-associated resistant infections globally.

Call for Greater Awareness and Diagnostics

Greater awareness and improved diagnostics are essential for responsible antibiotic use. Dr. Kamini Walia pointed out that “Since antibiotics are cheaper than diagnostics, doctors often prescribe them without following proper diagnostic rules.” Therefore, educating both the public and physicians on responsible antibiotic use is crucial. Hospital-acquired infection programs primarily target tertiary care hospitals with ICUs, where severely ill patients receive life-saving, higher-generation antimicrobials. Many patients survive major surgeries only to succumb to infections later, underscoring the urgent need for action. Recent Indian estimates on the burden of these infections help shape hospital policies, advocating for sensitization, resource allocation, infection controllers, and strict protocols to reduce HAIs. AMR could lead to up to 10 million deaths per year globally by 2050, emphasizing the critical need for interventions.

Frequently Asked Questions

Q1: What is Antimicrobial Resistance (AMR)?

Antimicrobial Resistance (AMR) occurs when microbes, such as bacteria, viruses, fungi, and parasites, evolve and become resistant to the drugs designed to kill them. This makes infections harder to treat, increases the risk of disease spread, severe illness, and death.

Q2: Why is inappropriate antibiotic use a major concern for AMR in India?

In India, inappropriate antibiotic use, including unnecessary prescriptions, prolonged durations, self-medication, and over-the-counter sales, creates "antibiotic pressure" that accelerates the development of drug-resistant microbes. This makes common infections difficult or impossible to treat effectively.

Q3: How do hospital-acquired infections (HAIs) contribute to the AMR crisis?

Hospital-acquired infections (HAIs) are infections patients acquire while receiving medical care, often in healthcare facilities. Hospitals can become breeding grounds for resistant organisms. When HAIs occur, especially with resistant pathogens, they prolong hospital stays, increase treatment costs, and contribute to higher mortality rates, thereby exacerbating the overall AMR burden.

References

Experts at CIDSCON 2025 Call for Multi-Faceted Approach to Combat AntimicrobialResistance – ETHealthworld
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