Dr. Samjhana Paudel, She serves as a Clinical Microbiologist at the Pokhara Academy of Health Sciences and earned her MD in Microbiology and Infectious Diseases from BPKIHS.<\/p>\n\n\n\n
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The desire for a safe and healthy existence is universal, from humans to the smallest creature. Maintaining good health requires practicing disease prevention strategies, nourishing the body with wholesome food, engaging in physical activity, and keeping a calm and positive mind.<\/p>\n\n\n\n
However, when the body\u2019s balance is disrupted or an autoimmune disorder occurs, the immune defenses weaken, allowing infections to gain control and cause disease. Every disease has a cause, possibly due to bacteria, viruses, fungi, or parasites. The well-known American author Zig Ziglar said, \u2018You cannot solve a problem until you acknowledge that you have one and understand its root cause.\u2019 Similarly, once the exact cause is identified, recovery tends to be faster because each cause requires specific treatment \u2014 antibiotics for bacteria, vaccines if available for viruses, antifungals for fungi, and antiparasitic drugs for parasites.<\/p>\n\n\n\n
In 1928, Sir Alexander Fleming discovered penicillin, a substance produced by a mold that killed bacteria. For this discovery, he\u2014along with Howard Florey and Ernst Boris Chain\u2014was awarded the Nobel Prize in Physiology or Medicine in 1945. According to the Centers for Disease Control and Prevention (CDC), antibiotics are drugs that kill certain kinds of germs called bacteria and stop their growth. Antibiotics are a critical tool for preventing and treating infections caused by specific bacteria in people, animals, and crops. Antibiotics act through the mechanism of selective toxicity; they attack the bacteria that cause the infection with variable side effects to the patients. The discovery of penicillin, also known as the magic bullet, marked the beginning of successful treatment and the dawn of new hope. Because infections earlier were difficult to treat where death was the only answer. Since then, discoveries of various other antimicrobial compounds have been made.<\/p>\n\n\n\n
According to the WHO, AMR occurs when bacteria, viruses, fungi, and parasite changes over time and no longer respond to medicines. Bacteria will survive, divide, multiply, and pass the resistance to the offspring via various mechanisms, either by vertical or horizontal transmission or mutations. This makes infections hard to treat and increases the risk of disease spread, severe illness, and death. As a result, the medicine becomes ineffective and the infection persists in the body, which increases the risk of spreading to others. This further spreads multidrug-resistant bacteria. Unfortunately, the current scenario is concerning as there remains a common misconception that antibiotics can treat all types of infection. However, inappropriate use promotes AMR.<\/p>\n\n\n\n
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CAUSES OF AMR<\/strong><\/h2>\n\n\n\n
Various challenges are fueling AMR, like limited public awareness, poor hygiene and sanitation, and weak infection control practices. Limited vaccination coverage, shortage of trained health workers, and poor access to quality healthcare add to the problem. The use of low-quality medicines, unregulated access to antibiotics without prescription, weak laboratory capacity, poor diagnostic training, and inappropriate prescribing practices all contribute to AMR. Moreover, the absence of appropriate antibiotic prescription, either escalation or de-escalation guided by culture and sensitivity results, further drives antimicrobial resistance.<\/p>\n\n\n\n
Even a fever may result from various conditions, including urinary tract infection, sepsis, pneumonia, formation of abscess, inflammatory condition, drug reaction, systemic disease, or other unknown origin. Establishing the precise cause is of utmost importance, as guessing and treating can promote and contribute to AMR. Microbes are everywhere. We have microorganisms in our body too, which are called normal flora, that are beneficial to us. Only the disease-causing pathogenic ones need treatment. Skilled diagnosis is vital to tell them apart. For this, trained unsung heroes working behind the scenes are the clinical microbiologists who support the treating physician by identifying the underlying cause of infection and recommending appropriate antimicrobial therapy to ensure quicker patient recovery.<\/p>\n\n\n\n
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IMPACT OF AMR<\/strong><\/h2>\n\n\n\n
AMR has become one of the top global public health and development threats. According to the Food and Agriculture Organization (FAO), 2018, bacteria and fungi cause significant plant disease and production losses worldwide. Antimicrobial pesticides play an important role in reducing losses in crop production. Some of the same drugs that are used in human and veterinary medicine, for example, streptomycin and tetracycline, are also used to control plant disease. The misuse and overuse of antimicrobials in humans, animals, and plants are the main drivers in the development of drug-resistant pathogens.<\/p>\n\n\n\n
AMR puts many of the gains of modern medicine at risk. Currently, the world is facing an antibiotics pipeline and access crisis. In addition to death and disability, AMR has significant economic costs. The World Bank estimates that AMR could result in US$1 trillion in additional healthcare costs by 2050 and US$1\u20133.4 trillion in gross domestic product losses per year by 2030.<\/p>\n\n\n\n
According to recent global surveillance updates from WHO (2025), 1 in 6 bacterial infections globally are resistant to standard antibiotics. Resistance increased by over 40% in key bacteria between 2018\u20132023, with an annual growth rate of 5\u201315%. Low- and middle-income countries (LMICs) face higher AMR burdens due to weaker health systems and limited diagnostic capacity. AMR was responsible for 1.27 million deaths worldwide in 2019 (AMR Collaboration, 2022), and this impact will become increasingly severe if action is not taken now.<\/p>\n\n\n\n
Nepal is among the 30 countries worldwide with a high burden of AMR. Resistant organisms such as Methicillin-resistant Staphylococcus aureus<\/em>, extended-spectrum beta-lactamase producers, Carbapenemase-producing Enterobacteriaceae<\/em>, Pseudomonas aeruginosa<\/em>, and Acinetobacter<\/em> species are frequently multidrug resistant (MDR), posing serious challenges in both healthcare settings and the community.<\/p>\n\n\n\n
According to the AMR newsletter published by the National Public Health Laboratory (NPHL), surveillance data revealed a high prevalence exceeding 50% of MDR bacterial isolates across 26 participating sentinel sites in Nepal.<\/p>\n\n\n\n
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APPROACHES TO COMBAT AMR<\/h2>\n\n\n\n
Nationally, the National Antimicrobial Treatment Guidelines 2023, published by the Ministry of Health and Population of Nepal. The Ministry of Health and Population of Nepal, with support from FHI 360 under the Country Grant Nepal, provides comprehensive guidance for the rational use of antimicrobials. The guideline includes detailed approaches to managing multidrug-resistant (MDR) organisms and outlines systematic treatment strategies for infectious diseases in both adult and pediatric populations.<\/p>\n\n\n\n
The NPHL, serving as the national coordinating center for AMR surveillance in Nepal, continues to collect AMR data from 26 sentinel sites across all seven provinces. Since 2018, NPHL has been reporting surveillance data on 12 bacterial priority pathogens through the WHO Global Antimicrobial Resistance Surveillance System (GLASS).<\/p>\n\n\n\n
Globally, various approaches have begun to combat AMR. Since 2017, the WHO has been publishing technical documents for the selection and use of essential medicines and has classified antibiotics under the WHO AWaRe classification, which many remain unaware of. This classification serves as a tool for monitoring antibiotic use, defining targets, and tracking the impact of stewardship policies and interventions that aim to optimize antibiotic use and curb resistance. Antibiotics are classified into three groups\u2014\u2018access\u2019, \u2018watch\u2019, and \u2018reserve\u2019\u2014considering their impact on resistance and emphasizing the importance of their appropriate use.<\/p>\n\n\n\n
Furthermore, to combat this alarming situation, coordinated multisectoral action has been implemented, such as the One Health approach, which is an integrated strategy aiming to achieve optimal and sustainable health outcomes for people, animals, and ecosystems. It recognizes that the health of humans, animals, plants, and the wider environment are closely linked and interdependent.<\/p>\n\n\n\n
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CONCLUSION<\/strong><\/h2>\n\n\n\n
Fighting AMR requires strong action across multiple areas. Prevention remains the first line of defense: ensuring access to clean water, proper sanitation, hygiene, and safe waste management can greatly reduce infections. Handwashing, first emphasized by Ignaz Semmelweis in 1847, continues to be one of the simplest and most effective ways to prevent disease.<\/p>\n\n\n\n
Expanding vaccination coverage, addressing vaccine hesitancy, and strengthening infection prevention and control programs are also vital. Everyone should have access to timely diagnosis, essential health services, and quality-assured treatment so that antibiotics are used appropriately and only when truly needed. Strong surveillance systems and innovative research guide better care and new solutions.<\/p>\n\n\n\n
Effective leadership, proper funding, and coordination across all sectors are necessary for making an impact. Most importantly, raising awareness among health workers and communities about responsible antibiotic use and hygiene practices can protect lives and preserve the power of these \u201cmagic bullets\u201d for the future.<\/p>\n\n\n\n
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Dr. Samjhana Paudel<\/strong><\/p>\n\n\n\n
Dr. Samjhana Paudel is a Clinical Microbiologist at the Pokhara Academy of Health Sciences, holding an MD in Microbiology and Infectious Diseases from BPKIHS. Her professional expertise spans infectious diseases, antimicrobial resistance (AMR), diagnostic stewardship, and infection prevention and control. She actively works to strengthen diagnostic microbiology services and support evidence-based clinical decision-making. Dr. Paudel is dedicated to advancing her knowledge in infection control and AMR management, aiming to enhance laboratory systems and promote the rational use of antibiotics in healthcare settings.<\/p>\n","protected":false},"excerpt":{"rendered":"
Dr. Samjhana Paudel, She serves as a Clinical Microbiologist at the Pokhara Academy of Health Sciences and earned her MD in Microbiology and Infectious Diseases from BPKIHS. The desire for a safe and healthy existence is universal, from humans to the smallest creature. Maintaining good health requires practicing disease prevention strategies, nourishing the body with …<\/p>\n","protected":false},"author":110,"featured_media":8882,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"","jetpack_seo_html_title":"","jetpack_seo_noindex":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[146,39,107,42],"tags":[],"class_list":["post-8881","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-cover-story","category-feature","category-flash-news","category-in-the-news"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/medicosnext.com\/wp-content\/uploads\/2025\/11\/Screenshot-2025-11-19-at-11.37.15-AM.png?fit=986%2C558&ssl=1","jetpack_likes_enabled":true,"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/posts\/8881","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/users\/110"}],"replies":[{"embeddable":true,"href":"https:\/\/medicosnext.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=8881"}],"version-history":[{"count":2,"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/posts\/8881\/revisions"}],"predecessor-version":[{"id":8896,"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/posts\/8881\/revisions\/8896"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medicosnext.com\/index.php?rest_route=\/wp\/v2\/media\/8882"}],"wp:attachment":[{"href":"https:\/\/medicosnext.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=8881"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicosnext.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=8881"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicosnext.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=8881"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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