Antibiotic resistance drives up child deaths, treatment costs amid measles outbreak
96 new confirmed measles cases recorded in 24 hours till yesterday morning
Highlights:
- Antibiotic resistance complicates measles treatment in critically ill children.
- DGHS reports nearly one lakh infections and 670 deaths.
- Many children no longer respond to common antibiotics.
- Experts urge immediate culture tests for ICU patients.
- Unnecessary antibiotic use across sectors worsens resistance crisis.
Five-and-a-half-year-old Abdullah was treated at two private hospitals in Dhaka for nearly two months after developing cold and cough symptoms. He was later diagnosed with measles and admitted to paediatric intensive care units several times.
After being transferred to a third hospital, tests reportedly showed that antibiotics were no longer effective against his infection. Abdullah died last month after his family spent more than Tk10 lakh on treatment.
Doctors say his case reflects a growing problem they are encountering in measles wards and intensive care units across the country.
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Antibiotic resistance is surfacing as a major challenge in treating children infected with measles, with doctors warning that it is increasing treatment costs and contributing to deaths alongside malnutrition.
Nearly one lakh children have been infected with measles across the country so far, while 670 have died from measles or related symptoms till yesterday morning, according to the Directorate General of Health Services (DGHS).
Doctors say many critically ill children are no longer responding to commonly used antibiotics, making treatment more difficult.
Experts have recommended that culture tests be conducted as soon as critically ill children are admitted to intensive care units so that the most effective antibiotics can be identified early.
Drug or antimicrobial resistance occurs when bacteria, viruses or fungi evolve over time and stop responding to medicines that previously treated them effectively.
The current measles outbreak was first noted in Rajshahi earlier this year. The first reports of deaths linked to measles and its symptoms emerged from Rajshahi Medical College Hospital in mid-March.
Since then, cases and deaths have been reported from districts across the country.
Dr Abu Hena Mostafa Kamal, head of the ICU at Rajshahi Medical College Hospital, said doctors initially believed malnutrition was the primary reason behind the high number of child deaths.
"In the beginning, we took about 18 children under observation and saw that at least 12 of them were suffering from severe malnutrition. But later, culture tests showed that an even bigger problem than malnutrition is antibiotic resistance," he told The Business Standard.
Doctors say many children are admitted to medical college hospital wards and ICUs after receiving treatment at district and upazila hospitals. Measles weakens immunity, making patients more vulnerable to secondary infections, particularly during prolonged hospital stays.
Culture tests key to treatment
According to Dr Kamal, reduced immunity allows bacteria and viruses to establish infections that become difficult to treat with standard antibiotics.
He said the mortality rate in his ICU remains relatively low because culture tests are carried out immediately after admission and treatment is tailored accordingly.
"In many cases, it has been seen that even though high-priced antibiotics were used beforehand, they did not work. After a proper culture test, patients recovered with lower-priced medicine," he said.
He added that unnecessary use of antibiotics has contributed significantly to resistance and called for routine culture testing in ICUs across the country.
Doctors also say antibiotic resistance is driving up healthcare costs. They point to the widespread and often unregulated use of antibiotics in humans, agriculture, poultry and fisheries as a major factor behind the problem.
"An illness that used to be cured with a Tk20 antibiotic earlier now requires a Tk5,000 antibiotic to cure," Dr Kamal said.
He stressed the need for a "One Health" approach, warning that unnecessary antibiotic use in livestock and fisheries must also be addressed.
The highest number of measles patients so far have been treated at DNCC Dedicated Covid-19 Hospital in Mohakhali.
Hospital spokesperson Dr Asif Haider told TBS that around 350 measles patients are currently admitted there, including about 45 in the ICU.
"The problem of antibiotic resistance has been happening from the very beginning. Common antibiotics are not working in the bodies of many children," he said.
He added that doctors are increasingly seeing children return to hospital with secondary infections after recovering from measles, with antibiotics proving ineffective in many cases.
"Although antibiotics are not directly required in the treatment of measles, they are often given to prevent secondary infections. However, unnecessary and presumptive use of antibiotics is making the situation more complex," he said.
Professor Dr Mirza Ziaul Islam, director of Bangladesh Shishu Hospital and Institute, said his hospital is also receiving patients with antibiotic-resistant infections.
"Giving antibiotics to children without a prescription must be stopped. At the same time, ensuring a clean environment is urgent," he said.
Notably, a total of 1,078 new suspected measles cases were reported just during the 24-hour period between Thursday and Friday morning, taking the cumulative number of suspected cases nationwide to 90,982.
Meanwhile, 96 new confirmed measles cases were recorded, bringing the total number of laboratory-confirmed infections to 10,869.
Since 15 March, a total of 75,156 patients with suspected measles have been hospitalised across the country, of whom 71,396 have recovered, according to DGHS data.
