In a stark warning about the dangers of self-medication, a senior doctor has detailed a troubling case where a patient's habit of taking over-the-counter antibiotics for the common cold years ago resulted in a life-threatening, drug-resistant pneumonia. Dr. Rommel Tickoo, Director of Internal Medicine at Max Healthcare, shared this incident to highlight the silent but rapid spread of antimicrobial resistance (AMR) in India.
The Case: From Common Cold to Untreatable Pneumonia
A 45-year-old man with no significant medical history was admitted to the intensive care unit with severe pneumonia. Despite his robust health and lack of co-morbidities, the standard antibiotics prescribed to him failed to work. Antibiotic sensitivity tests revealed that the most common drugs were completely ineffective against his infection.
Upon taking a detailed history, Dr. Tickoo uncovered the root cause. For years, the patient had been self-medicating with over-the-counter antibiotics every time he suffered from seasonal flu or a cold. He followed this practice blindly, often on the advice of his uncle, without understanding that antibiotics have no effect on viral infections like the flu.
Furthermore, he would stop the medication as soon as his symptoms subsided, never completing the full course prescribed for bacterial infections. This repeated and incorrect use of broad-spectrum antibiotics gradually blunted their efficacy, allowing bacteria in his body to develop resistance.
Why Antibiotic Resistance is Surging in India
Dr. Tickoo points to two primary drivers behind the alarming rise of superbugs in the country. The first is the rampant overuse and misuse of antibiotics by the public, as illustrated by this case. The second major contributor is hospital-acquired infection.
In critical care settings, patients with severe infections often require prolonged stays and invasive devices. This environment, where bacteria are heavily exposed to antibiotics, becomes a breeding ground for resistant strains. Doctors, under pressure to save lives, are sometimes forced to use high-end, last-resort drugs, which further accelerates the resistance cycle.
In the pneumonia patient's case, doctors identified a pan-resistant strain of Klebsiella bacteria in his blood and chest. With standard treatments useless, they had to resort to powerful carbapenems, a class of last-resort antibiotics. The use of such drugs creates intense selective pressure, allowing only the strongest, most resistant bacteria to survive and multiply.
How Resistant Bacteria Spread and Linger
The spread of these superbugs within hospitals is alarmingly efficient. They can move from patient to patient via contaminated surfaces like bed rails, sinks, and drains, or through the hands and clothing of healthcare workers if strict hygiene protocols are not followed.
These stubborn bacteria often form a protective biofilm, which can increase their resistance by a staggering 10 to 1,000 times compared to free-floating bacteria. This allows them to survive on surfaces for long periods and persist in plumbing systems, turning hospital facilities into permanent transmission hubs.
Even after recovery, a patient can become a silent carrier or colonised with AMR bacteria for years, unknowingly spreading these resistant strains to their community or other healthcare settings. Global travel further accelerates this worldwide spread.
Controlling the AMR Crisis: A Collective Responsibility
Combating this threat requires disciplined action from all stakeholders. For doctors, the mantra is precision: prescribe antibiotics only when necessary, start with narrow-spectrum options, and always follow the correct dose and duration. Dr. Tickoo emphasizes the critical need for culture sensitivity tests of blood, urine, or sputum to guide accurate diagnosis and prescription.
Hospitals must strengthen infection control and sterilization protocols and maintain an antibiogram—a local map of which antibiotics work against prevalent bacteria—to guide effective empiric therapy for severe infections.
At the policy level, there is an urgent need to ban over-the-counter sales of antibiotics without a prescription. For individuals, the lesson is clear: never self-medicate with antibiotics. Vaccinations to prevent infections are far more effective than popping pills on a pharmacist's advice. The case from December 2025 stands as a cautionary tale of how everyday misuse can fuel a global health crisis.
