Experts have flagged the growing threat of antimicrobial resistance, stating that it is making even routine surgical procedures more challenging. The surgeons are warning that the loss of effective antibiotics could undermine decades of progress in safe surgery and increase the risk of life-threatening post-operative infections.
Surgeons say that while antibiotics remain critical in preventing surgical site infections, their indiscriminate use has fuelled resistance, forcing hospitals to adopt stricter antibiotic stewardship practices and emphasise infection prevention measures over prolonged antibiotic prescriptions.
Modern surgery depends as much on effective antibiotics as it does on surgical skill, Dr Amarchand Bajaj, senior consultant for general surgery at the Sitaram Bhartia Institute of Science and Research, said."Whether it is an appendectomy, gall bladder surgery or major gastrointestinal surgery, the inability to treat infections due to resistant bacteria can significantly increase complications and prolong hospital stays," Bajaj said.
According to the World Health Organization (WHO), surgical site infections are the most common healthcare-associated infections in low and middle-income countries, affecting up to 11 per cent of patients undergoing surgery.The WHO's global guidelines recommend that antibiotics for surgical prophylaxis should generally be administered before incision and should not be routinely continued after surgery in most cases, as prolonged use offers little benefit while contributing to antimicrobial resistance (AMR).Bajaj said the misconception that "more antibiotics mean better protection" continues.
"Optimising diabetes before surgery, encouraging smoking cessation, maintaining strict operating theatre sterility, proper skin preparation, timely antibiotic administration and early mobilisation after surgery are all equally important in preventing infections. Antibiotics alone cannot compensate for poor infection-control practices," Dr Asuri Krishna, professor in the department of surgery at AIIMS Delhi, said.
Globally, AMR is already exacting a heavy toll. A widely cited analysis published in The Lancet estimated that 1.27 million deaths were directly attributable to bacterial antimicrobial resistance in 2019, while 4.95 million deaths were associated with drug-resistant bacterial infections, making AMR one of the leading public health threats worldwide.
These trends have significant implications for surgical care, where effective antibiotics are indispensable for both preventing and treating postoperative infections, Krishna said. Dr V K Bansal, professor in the department of surgery at AIIMS Delhi, said that antimicrobial stewardship programmes in hospitals have become central to surgical practice.
The surgeons also called for greater public awareness, noting that patients often expect antibiotics to continue for several days after surgery despite international guidelines recommending otherwise for most clean surgical procedures.
"As bacteria become increasingly resistant, preserving the effectiveness of existing antibiotics is everyone's responsibility. Every surgeon, every hospital and every patient has a role in ensuring these life-saving drugs remain effective for future generations," Bansal said.
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