Over the past few decades, antimicrobial resistance (AMR) has shaped up to be one of the most important and crucial global health issues, and countries like Bangladesh, which have poor and weak health care systems are at the highest risk. Lack of awareness and insufficient knowledge about AMR, inappropriate usage of antimicrobial medicines, and inadequate supervision regarding the sale and usage of antimicrobial drugs are aggravating the situation. It would be impossible to tackle the worsening AMR situation in Bangladesh unless the mentioned issues are addressed and effective measures are taken to improve the overall health care system of the country.


Antimicrobial resistance occurs when microorganisms (such as bacteria, fungi, viruses, or protozoa) are able to neutralize the effects of antimicrobial medications, rendering them useless. This ability to nullify the action of antimicrobial medicine is not an inherent characteristic of the microbes, rather it is developed over time. According to the World Health Organization (2021), the mistreatment and overuse of antimicrobials, lack of access to safe water, sanitation, and hygiene, along with inadequate infection and disease prevention and control in healthcare institutions, and farms are the major causes of antimicrobial resistance. Even though a large number of factors are responsible for this, the overuse and wrong application of antimicrobial medicines serve as the main driving force behind this exponential rise in AMR cases in recent years (WHO, 2021). Each year nearly 700,000 preventable deaths are directly linked to AMR and this number is projected to rise exponentially and cross 10 million deaths annually by the end of 2050 as stated in a report by O’Neill (2016).

South-east Asia is one of the most vulnerable regions and possesses the highest risk when it comes to AMR and Bangladesh is no different (Chereau et al., 2017). According to a report published by Jasim (2019), cases related to AMR in Bangladesh is on the rise throughout the last few years and experts suggest that there will be an exponential rise in the near future if the present situation is left unnoticed. According to data from the Bangladesh Society of Anesthesiologists (2013), the percentage of patients admitted to Bangabandhu Sheikh Mujib Medical University Hospital (BSMMU) ICU showing the signs of multi-antibiotic resistance is 52% and the number is rapidly growing. Thus, it has become an absolute necessity to raise awareness about AMR in Bangladesh and control the situation before it gets out of grasp.

Assessment of the Situation in Bangladesh

Various factors are responsible for the current state of antimicrobial resistance in Bangladesh. Jasim (2019) in his report, pointed out, most of the health officials and physicians in the country suggest that apart from the overuse and inappropriate application of medicines, the lack of enforcement of legislative regulations plays a vital role in the increment of AMR in Bangladesh. Despite having laws that prohibit the sale of antibiotics without a valid prescription by a doctor, most pharmacies in the country continue to sell different antibiotic and antimicrobial medicines over-the-counter (OTC) without any valid prescription (Darj et al., 2017). In addition, according to a recent research article published by Hoque et al. (2020), the prevalence of self-treatment and the tendency of administering drugs on their own by the patients without the prescription of a registered physician is dangerously high in Bangladesh. The article concluded that the percentage of people consuming some form of medicine without consulting a doctor is 36% for food poisoning, 28% for the common cold, and 13% for presumed infections; among which only 17.5% of people have knowledge about antibiotics. The overuse and misuse of certain antibacterial drugs have caused various bacteria like Escherichia coli, Streptococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae to become highly resistant to antibiotic medicines. For instance, 86% of E. coli bacteria collected from urine samples from hospitals of Dhaka showed a high level of resistance towards amoxicillin and ceftazidime, two well-known antibiotics (Hasan, 2019). On the other hand, similar kinds of drug-resistant bacteria can also enter the human body through the consumption of poultry, fish, and meat. Studies conducted by a group of researchers of the Chittagong Veterinary and Animal Sciences University (CVASU) conclude that more than 19 types of antibiotics are used in poultry farms and fisheries all over the country. This has led to 54.55% of broiler chickens carrying one or more multi-drug resistant bacteria (Khan et al., 2020).

As antimicrobial resistance has turned into a major health issue in Bangladesh, immediate actions have to be taken. Firstly, mass awareness has to be raised about the present condition of AMR in Bangladesh and how it will affect the future, as only 17.5% of people in Bangladesh who regularly consume some forms of antimicrobial drugs are aware of the adverse effects of AMR as stated by Hoque et al. (2020). Secondly, strong legislative actions should be taken to stop the sale of antibiotics and antiviral medicines unless a valid prescription by a certified physician is presented. Thirdly, and most importantly, the medical infrastructure of the countries should be improved and diagnostic procedures should be developed and effectively utilized so that the pathogen responsible for the infection is identified accurately and medications are suggested accordingly. Successful monitoring and execution of these steps will help to minimize the risk of AMR in Bangladesh.


To conclude, as the AMR situation is worsening and more species of microbes are exhibiting signs of anti-microbial resistance in Bangladesh, it is of utmost importance that mass awareness programs are initiated along with strict regulatory methods and supervision. Awareness is at the forefront when it comes to eradicating AMR as most of the factors that lead to the development of drug resistance in microbes are linked to a lack of awareness among people. If the mass population comes to know about the adverse effects of antimicrobial resistance, it would be easier to control infectious diseases and the misuse of antimicrobial medicines could be reduced.



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