Are Antibiotics Failing? ICMR Study Finds 1 In 5 Infections Resistant To Carbapenem Drugs

Last Updated:February 18, 2026, 10:38 IST

Patients with drug-resistant infections are showing very high mortality and often require prolonged hospital stays, significantly increasing treatment costs for families

A large multi-centre study by India’s apex medical research body, Indian Council of Medical Research (ICMR), tracking nearly 1.5 lakh hospitalised patients, has found that about 20 per cent of admitted patients developed infections—and among those infected, one in five showed resistance to carbapenems, a powerful class of last-resort antibiotics. These patients were admitted to 20 public and private hospitals across India.

In an exclusive conversation with News18, Dr Kamini Walia, senior scientist at ICMR and a key figure in India’s antimicrobial resistance (AMR) surveillance efforts, described the findings as “alarming", particularly because carbapenems are widely used in hospitals and are part of the National Essential Medicines List.

“We are only talking about admitted patients here. Almost 20 per cent of them had some kind of infection. And when we further look at the patients with infections, one in five had carbapenem-resistant infections," she said.

Carbapenems are broad-spectrum antibiotics typically reserved for very sick patients with serious infections. Resistance to these drugs severely limits treatment options.

“Management of carbapenem-resistant pathogens is very problematic because there aren’t many treatment options left," Walia said, adding that second-line drugs such as colistin can be nephrotoxic and ototoxic, and many patients are unable to tolerate them.

She said patients with drug-resistant infections are showing very high mortality and often require prolonged hospital stays, significantly increasing treatment costs for families. “Not all infections have become untreatable, but a large proportion are now being caused by drug-resistant pathogens, which is resulting in complicated illness and deaths," she said.

Updated Antibiotic Policy Needs More Data

Walia noted that the current dataset is drawn from 20 hospitals across India and needs to be extrapolated nationally to generate a more accurate disease burden estimate.

“Until recently, surveillance largely focused on tertiary care centres such as All India Institute of Medical Sciences and Postgraduate Institute of Medical Education and Research, which tend to report higher resistance because they treat critically ill and referred patients."

From 2025 onwards, she said, ICMR has begun analysing data from secondary-level district hospitals as well, to help shape more appropriate antibiotic policies. “Appropriate antibiotic policy cannot be made only on tertiary care data. We need lower-level data as well," she said.

India currently operates two national AMR surveillance networks — one under ICMR and another under the National Centre for Disease Control — which collect resistance data from microbiology laboratories. However, Walia acknowledged that much of the lab data is not yet fully linked to patient outcomes, limiting precise national estimates.

PM Modi’s Message On AMR Timely

On antibiotic misuse, she echoed a message often cited by the prime minister: “Medicines need guidance and antibiotics need doctors." Antibiotics, she said, must not be treated as consumer products. “If we continue to use antibiotics irresponsibly, we should get prepared for longer treatment, more expensive treatment, and in some cases, no recovery at all."

Walia stressed that antibiotic stewardship must be supported by reliable diagnostics and infection control systems. She pointed out that culture testing rates before starting antibiotics remain low in many settings, leading to widespread empirical use of broad-spectrum drugs. “Once you get the culture result, you should de-escalate and give a narrow-spectrum drug. Broad-spectrum antibiotics will further select more mutants and more drug-resistant bacteria," she said.

She also referred to regulatory steps taken in recent years, including a 2021 mandate by the National Medical Commission requiring medical colleges to establish antimicrobial stewardship committees to regularly review antibiotic use and hospital policies.

Broader initiatives under the National Health Mission and infection prevention programmes are also aimed at strengthening district-level capacity.

While a few new antibiotics have entered the Indian market in recent years, Walia cautioned that global innovation pipelines remain limited and access to newer agents is still evolving. “We definitely need more innovation in discovery of new antibiotics, as well as regulatory frameworks which expedite introduction of antimicrobials discovered elsewhere," she said.

Despite the scale of the challenge, she remained cautiously optimistic, pointing to India’s National Action Plan on AMR as a coordinated effort across ministries and stakeholders. If implemented effectively and funded adequately, she said, the country can mitigate the impact and save lives.

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