Four in 10 ICU patients not responding to antibiotics: IEDCR

• Pan-drug-resistant bacteria found in 41% of ICU samples
• Use of watch-group antibiotics jumps to 91%
• 89% of ICU samples show multidrug resistance
• Misuse, over-prescription, self-medication driving AMR

Four in every 10 patients admitted to intensive care units (ICUs) are not responding to available antibiotics due to their overuse and misuse, according to government data released today, raising fresh concerns about the growing threat of antibiotic resistance.

The latest findings from the National Antimicrobial Resistance (AMR) Surveillance by the Institute of Epidemiology, Disease Control and Research (IEDCR) show an alarming rise in antibiotics losing effectiveness. Use of "watch group" antibiotics -- meant for second-tier treatment -- has surged from 77 percent last year to 91 percent this year.

The AMR surveillance, conducted on 96,477 patients between July 2024 and June 2025, was unveiled at IEDCR's Mohakhali office today to mark the ongoing World AMR Awareness Week.

According to the World Health Organisation (WHO), AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to antimicrobial medicines, making infections difficult or impossible to treat and increasing the risk of severe illness, disability, and death.

Health experts cited over-prescription, patients' ignorance and negligence in not completing antibiotic courses, excessive use of antibiotics in livestock and fisheries, poor infection control in hospitals, inadequate hygiene and sanitation, and the lack of new antibiotics as key drivers of AMR.

They warned that rising resistance will lead to more critical illnesses, prolonged hospital stays, treatment failures, higher mortality, greater healthcare costs, and reduced productivity.

What new findings reveal

Presenting the data, Prof Zakir Hossain Habib, chief scientific officer of the IEDCR, said the surveillance used case-based data from 13 hospitals and lab-based data from eight hospitals and diagnostic centres. Researchers analysed 123 drug-bug combinations and compared them with last year's results.

The data show that susceptibility rates fell for 79 combinations, improved for 38, and remained unchanged for six, indicating that more antibiotics are becoming ineffective.

"More and more antibiotics are showing resistance to different antibiotics," he said.

In ICUs, 71 antibiotics were tested against five pathogens. Only five organism-drug combinations showed susceptibility above 80 percent, while one fell between 60 and 80 percent. All others were below 60 percent, meaning antibiotic efficacy dropped under that threshold.

The data also reveal that Pan-Drug-Resistant (PDR) organisms -- resistant to all tested antibiotics -- were found in 7 percent of all specimens and in 41 percent of ICU samples. Acinetobacter, a kind of bacteria, showed the highest rate of suspected PDR at 27 percent.

Prof Habib called this "a real threat, especially in ICUs".

He said 46 percent of overall samples contained multidrug-resistant (MDR) pathogens, while MDR prevalence in ICUs was 89 percent. The most common pathogen identified was E. coli (35 percent), followed by K. pneumoniae (19.2 percent).

Among WHO's critical priority pathogens, ceftriaxone resistance in K. pneumoniae rose from 40.1 percent in 2022 to 52.2 percent in 2025. Resistance to meropenem -- a widely used watch-group drug -- increased from 46.7 percent to 71 percent over the same period.

WHO divides antibiotics into three categories -- Access, Watch, and Reserve -- to guide proper use. Access-group drugs should be used as first- or second-line treatments. Yet the use of watch-group antibiotics rose sharply to 91 percent this year.

"This increasing reliance on watch-group antibiotics is deeply alarming," Prof Habib said.

IEDCR recommended that culture and sensitivity tests be performed before prescribing antibiotics to ensure the right drug is used. It also stressed strict infection prevention and control practices and stronger antibiotic stewardship to reduce pressure on commonly used drugs.

At the event, Prof Sheikh Sayidul Haque, additional director general (planning and development) of the Directorate General of Health Services (DGHS), said self-medication and antibiotics prescribed by unregistered practitioners continue to fuel misuse. He acknowledged that even registered doctors do not always follow proper prescribing procedures.

Abu Hussain Md Moinul Ahsan, director (hospital) of DGHS, said infection control in hospitals remains challenging due to overwhelming patient loads but noted efforts are underway to improve the situation.

IEDCR Director Prof Tahmina Shirin said the aim of releasing the findings was to raise awareness.