Growing AMR crisis: A silent public health threat

Imagine a future where a simple cut could lead to dire consequences, minor infections become untreatable, and routine medical procedures carry life-threatening risks. This isn’t just the storyline of a dystopian film; it’s the alarming reality we are facing due to antimicrobial resistance (AMR). The overuse and misuse of antibiotics are fuelling the rise of superbugs that are outsmarting modern medicine.

“In Malaysia, the situation is increasingly critical. Even common ailments, such as a sore throat, are contributing to this growing crisis, and the potential fallout could be catastrophic,” warns Associate Professor Dr. Petrick Periyasamy, Clinical Physician and Consultant in Infectious Diseases
Head of Infectious Diseases, Universiti Kebangsaan Malaysia Medical Centre.

Globally, AMR has been recognized as one of the top 10 health threats by the World Health Organization (WHO). A 2019 study published in The Lancet reported that drug-resistant infections caused 1.27 million deaths worldwide—exceeding fatalities from HIV/AIDS and malaria combined. Without urgent intervention, AMR could claim up to 10 million lives annually by 2050, surpassing cancer as the leading cause of death.

In economic terms, AMR could result in a staggering global GDP loss of $100 trillion. If Malaysia does not take immediate action, the country’s healthcare system could be overwhelmed by rising treatment costs, prolonged hospital stays, and a surge in untreatable infections.

The Root Cause of AMR

The increasing threat of AMR in Malaysia can be largely attributed to the misuse and overprescription of antibiotics. A study conducted at the primary care clinic of University Hospital Kuala Lumpur found that 64% of pharyngitis cases were viral, meaning they did not require antibiotics. Despite this, antibiotics continue to be widely prescribed for such infections.

“Recent studies raise concerns about antibiotic overprescription. A cross-sectional study conducted in private primary care clinics in Malaysia found that only 42.9% of antibiotic prescriptions for acute pharyngitis were appropriate, while over 58.5% of prescriptions were deemed excessive,” Dr. Petrick highlights.

The problem extends beyond clinics. A study on Upper Respiratory Tract Infection (URTI) patients in an Emergency Department on Malaysia’s east coast (2018–2019) found that 29% received inappropriate antibiotic prescriptions. This misuse accelerates bacterial resistance, creating an environment where previously manageable infections become deadly.

Superbugs and the Burden on Healthcare

The consequences of AMR are already evident in Malaysia’s hospitals, where drug-resistant bacteria such as Methicillin-resistant Staphylococcus aureus (MRSA) and Carbapenem-resistant Enterobacteriaceae (CRE) are spreading rapidly.

“Superbugs in Hospitals – Dangerous drug-resistant bacteria like Methicillin-resistant
Staphylococcus aureus (MRSA) and Carbapenem-resistant Enterobacteriaceae (CRE) are
spreading through Malaysian hospitals, making previously manageable infections nearly
impossible to treat,” warns Dr. Petrick.

AMR is also placing a significant burden on Malaysia’s healthcare system. The cost of treating drug-resistant infections is up to three times higher than treating non-resistant cases, leading to increased financial strain on hospitals and patients alike.

A World Bank study warns that by 2050, AMR could shrink the global economy by 3.8%, pushing 28 million people into poverty. Malaysia’s healthcare system, already under strain, risks collapsing under the weight of rising medical costs and treatment failures.

Combating AMR

Recognizing the urgent need for action, Malaysia has introduced the Malaysian Second Action Plan on Antimicrobial Resistance (MyAP-AMR) 2022–2026, which builds upon its initial 2017 framework and aligns with WHO’s Global Action Plan. This strategy adopts a One Health approach, integrating efforts across human health, animal health, and environmental sectors.

Key initiatives include:

• Enhanced Governance: Strengthening the National Antimicrobial Resistance Committee (NARC) to coordinate AMR-related activities effectively.
• Surveillance and Research: Expanding monitoring systems to track AMR trends in healthcare and agriculture.
• Infection Prevention and Control (IPC): Implementing stringent IPC measures in hospitals and promoting best practices in animal husbandry.
• Optimized Use of Antimicrobials: Enforcing regulations on antibiotic sales and promoting antimicrobial stewardship programs.
• Public Education and Awareness: Conducting nationwide campaigns to debunk antibiotic misconceptions and promote responsible usage.

Dr. Petrick stresses that both healthcare practitioners and the public have a role in combating AMR. “First, avoiding self-medication is key—never take antibiotics without a doctor’s prescription. Additionally, patients should also trust healthcare professionals when they advise that antibiotics are unnecessary, as improper use only accelerates resistance. Finally, raising awareness within communities can help curb misinformation about antibiotics and their misuse. Educating family and friends on the dangers of AMR will encourage responsible antibiotic consumption and promote long-term public health benefits.”

If Malaysia fails to act now, the consequences could be devastating. A post-antibiotic era—where once-minor infections become fatal—could become a reality. “The time to act is NOW. The Malaysian government, healthcare professionals, and the public must work together to combat this escalating threat. The moment for complacency has passed—the battle for our health begins today,” urges Dr. Petrick.