ISLAMABAD: Irrational use of thirdand fourth line antibiotics, particularly in hospitals, has led to the emergence of bacteria that are increasingly difficult to treat, resulting in prolonged hospitalisation, higher treatment costs and rising mortality, experts warned on Wednesday. While no concrete data exists on deaths attributed to drug resistance, thousands of lives are believed to be lost annually to infections caused by resistant pathogens. This has prompted experts to urge a multisectoral approach to combat what is being termed as a silent, emerging pandemic. Speakers commended the health ministry alongside the National Institute of Health (NIH) for their efforts to combat antimicrobial resistance (AMR). “AMR is responsible for a significant burden of infections that are increasingly difficult to treat due to drug resistance. The emergence of extensively drug-resistant (XDR) infections at the community level and the growing prevalence of hospital-acquired bloodstream infections have become harder to treat,” said Dr Mohammad Salman, Executive Director NIH. He was speaking at the inaugural session of the National Symposium on AMR, organised as part of World Antimicrobial Awareness Week 2024 (WAAW) by the NIH in collaboration with the WHO, Fleming Fund, Health Services Academy (HSA), and Getz Pharma. Deputy Director of Programmes at the Ministry of National Health Services, Dr Atiya Abro, highlighted that AMR not only threatens human health but also endangers food security by affecting livestock and crop health. She warned that resistant pathogens reduce agricultural productivity and contribute to environmental contamination, further spreading resistance genes. Getz Pharma’s Lead of Public Health, Jaffer Bin Baqar, said they were working with NIH and other partners to tackle AMR by training over 15,000 healthcare providers nationwide and creating awareness about avoiding self-medication and the irrational use of antibiotics. Senior NIH scientist and AMR lead, Dr Omera Naseer, revealed that a study conducted by her in 11 tertiary care hospitals found that 91pc of patients were prescribed antibiotics, many unnecessarily. She maintained that most hospitals lack antibiotic guidelines and do not conduct lab cultures for accurate prescriptions, leading to drug-resistant pathogens. “We are working with these hospitals and others to promote antimicrobial stewardship and rational use of antibiotics,” Dr. Omera Naseer stated. The economic burden of AMR was highlighted by NIH’s senior pharmacist and AMR specialist, Numrah Safdar. She shared findings from studies at Holy Family Hospital in Rawalpindi and Pims Islamabad, which showed that AMR significantly increased treatment costs and prolonged hospital stays. The symposium was also addressed by experts, including Dr. Qadeer Ahsan from Fleming Fund, Dr. Naveed from WHO, and Dr. Shaheer Illahi from HSA. A panel discussion featuring Dr. Munazza, Mohammad Akram, and Dr Hifza Rasheed further emphasised the urgent need for stewardship programs and collaboration among healthcare, agriculture, and environmental sectors to address the growing threat of AMR.