Superbugs, or microbes that no longer respond to medicines, are spreading faster than new treatments are being discovered. Hospitals, where antibiotics are used frequently, are among the most vulnerable places for these resistant strains to emerge.

“We are already living in a post-antibiotic era,” says Dr Sanchita Mitra, consultant microbiologist at L V Prasad Eye Institute. “Many of the drugs that were once dependable no longer work. Even colistin, which we used to rely on as a last resort, is now failing in some cases.”

Superbugs evolve when bacteria are exposed repeatedly to antibiotics in hospitals, agriculture, and even through sewage. Over time, some bacteria survive the drugs and multiply. Others can pass along resistance traits to different species. “They are incredibly adaptable,” Dr Mitra explains. “And they can share resistance like handing over a survival toolkit.”

On World Microbiome Day, observed on June 27, experts stress the need to protect the delicate balance of microbes around us. This includes microbes that live in the environment, the body, and health care settings.

To control resistance, many hospitals follow antimicrobial stewardship programmes. These programmes are built around data from the previous year, collected from different hospital departments. “We study infection trends and resistance patterns to create a yearly policy,” Dr Mitra says. “This policy guides doctors on which antibiotics to use for specific infections, how much to give, for how long, and in what form.”

Antibiotics are grouped based on how well they work. If a drug kills fewer than 90 percent of bacterial samples, it is considered a first-line medicine. More powerful ones are treated as second-line options and used only when the first fails. “This helps us protect our strongest antibiotics from overuse,” she says.

But policies alone are not enough. “Hospital-acquired infections are often preventable if basic hygiene protocols are followed,” Dr Mitra points out. “Hand washing, proper handling of bed linen, and staff vaccination are all part of a working infection control system. We keep training our staff because these practices can slip over time.”

Hospitals also dispose of large quantities of medicines. If antibiotics are flushed or thrown into drains, they can contaminate sewage and fuel further resistance. “We send all unused or expired drugs to certified waste plants,” she says. “They are either incinerated or treated based on government guidelines.”

Outside hospitals, the bigger challenge lies in everyday exposure. “From medicated soaps to animal farming, antibiotics are everywhere,” Dr Mitra says. “Until everyone understands the risk and uses them responsibly, the problem will only grow. Antibiotics are not just medicines. They are a resource that must be preserved.”