India amongst worst-hit by AMR as 1 in 6 bacterial infections resisted antibiotics globally

According to the Global Antibiotic Resistance Surveillance Report 2025 published by the WHO (World Health Organization) in 2023, approximately one in six laboratory-confirmed bacterial infections worldwide were caused by bacteria resistant to at least one antibiotic treatment. The antibiotic resistance is a sub-set of a much larger phenomenon known as AMR (anti-microbial resistance) which involves microbes like bacteria developing resistance for prescribed medications.

This growing resistance undermines the effectiveness of available therapies, jeopardising patient outcomes and straining healthcare systems globally.

Resistance was notably prevalent among bacteria responsible for urinary tract and bloodstream infections, with lower levels observed in those causing gastrointestinal and urogenital gonorrhoeal infections.

The WHO report highlights that the South-East Asia Region, including India, and the Eastern Mediterranean Region recorded the highest resistance rates, reaching almost one in three infections, markedly above the global average. The African Region followed with about one in five infections showing resistance.

India’s AMR landscape

The report spotlights India’s severe resistance challenges. In 2023, 71 per cent of bloodstream infections caused by Acinetobacter spp. were resistant to imipenem, an essential last-resort antibiotic. Similarly, resistance to cefotaxime among Escherichia coli infections exceeded 78 per cent.

Nearly 41,400 bloodstream infections were documented in India during the year, predominantly driven by Acinetobacter spp., E. coli, Klebsiella pneumoniae, and Staphylococcus aureus.

Between 2018 and 2023, over 40 per cent of pathogen-antibiotic combinations analysed demonstrated an escalating resistance trend, growing at annual rates between 5 and 15 per cent.

This increase outpaces the development of new antibiotics and poses a severe threat to global health security.

Global health implications

Participation in the WHO’s GLASS (Global Antimicrobial Resistance and Use Surveillance System) has expanded significantly, with 104 countries submitting data in 2023 — a fourfold increase from 25 countries in 2016 —reflecting greater international commitment to monitoring resistance trends.

Notably, the highest participation rates came from the South-East Asia and Eastern Mediterranean regions.

However, gaps remain as nearly half of WHO member countries did not provide data in 2023, particularly those bearing the greatest burdens of resistance, underscoring persistent challenges in data collection and reporting capacities globally.

Antibiotic resistance prolongs illness duration, increases hospital stays, drives up healthcare costs, and complicates infection control measures. The gradual loss of effective antibiotic options threatens the management of common infections and complicates surgeries and cancer treatments, undermining medical progress.

WHO emphasises a One Health approach, integrating human, animal, and environmental health sectors to combat resistance comprehensively. Countries are encouraged to improve surveillance quality, expand access to diagnostics and quality medicines, enforce stewardship programmes, and promote innovation in antibiotic development.

Key findings from the WHO report:

• Approximately one in six bacterial infections globally in 2023 were antibiotic-resistant.

• Resistance was highest in urinary tract and bloodstream infections.

• South-East Asia and Eastern Mediterranean regions exhibited resistance in almost 33 per cent of cases.

• African region reported approximately 20 per cent resistance rates.

• India saw 71 per cent resistance to imipenem in Acinetobacter spp. bloodstream infections, and 78 per cent resistance to cefotaxime in E. coli infections.

• Over 40 per cent of pathogen-antibiotic pairs show increasing resistance with annual growth rates of 5-15 per cent.

• Participation in GLASS increased to 104 countries in 2023, highlighting growing global commitment.

• Key challenges include insufficient data reporting from high-burden countries and lack of uniform surveillance capacity.

• Antibiotic resistance threatens to outpace current medical advancements, requiring urgent multisectoral action.

WHO Director-General Tedros Adhanom Ghebreyesus warned, “Antimicrobial resistance is outpacing advances in modern medicine, threatening the health of families worldwide.”

The report underscores the critical need for sustained international focus to preserve the effectiveness of antibiotics and safeguard global health.