Antimicrobial resistance and its impact on cancer treatment in Bangladesh

Thanks to advancements in medical treatment, a diagnosis of cancer is no longer a death sentence. Chemotherapy, surgery, and targeted therapies have all come a long way, and these have significantly improved survival rates around the world. But in Bangladesh, a quieter and more dangerous threat is expanding that could undo decades of medical progress: antimicrobial resistance (AMR).

Antimicrobial resistance is seen when bacteria adapt to survive drugs designed to kill them. The Institute for Health Metrics and Evaluation says that AMR is accountable for over 30,000 deaths annually in the country. Furthermore, as the Institute of Epidemiology, Disease Control and Research notes, common bacterial pathogens are highly resistant, especially in hospitals.

Radiation therapy and chemotherapy are cancer treatments that weaken the immune system, resulting in patients becoming very vulnerable to infections. Even routine activities may introduce bacteria into the body. Antibiotics are vital for preventing infections while receiving treatment. But these protections fail when bacteria become resistant. Research shows that cancer patients who are in the hospital are much more likely to get infections that are resistant to treatment, which can lead to serious health problems and even death.

In Bangladesh, hospitals, especially in tertiary care centres, serve as critical hotspots for the emergence and dissemination of antimicrobial resistance. Overcrowding, poor infection control, and widespread use of antibiotics without testing speed up the spread of multidrug-resistant organisms.

Some common pathogens, like Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus (MRSA), are now resistant to first-line antibiotics, which means that doctors have to use treatments that are more expensive or harder to get.

The effects of AMR extend far beyond controlling infections. They directly impact cancer treatment—causing chemotherapy cycles to be delayed or discontinued, making surgeries more dangerous, and prolonging hospital stays at greater cost. These challenges are even more acute in a healthcare system like Bangladesh's.

Several systemic failures are driving the rapid rise of antimicrobial resistance. Antibiotics are freely available without prescriptions. Drugs are taken without prior diagnostic testing. Infection prevention and control measures remain inadequate. Compounding this, most people have little awareness of how to use antibiotics correctly. Together, these conditions allow resistance to spread unchecked.

Addressing AMR in cancer care demands urgent, coordinated action. This means strengthening antibiotic stewardship programmes in hospitals, expanding diagnostic facilities to enable targeted treatment, improving national surveillance systems, and investing in public awareness campaigns, research, and innovation.

Without these steps, life-saving cancer treatments will continue to lose their effectiveness. Killing cancer cells is no longer enough. We must also preserve the tools that protect patients from infection. AMR risks making routine treatments hazardous and complex procedures nearly impossible.

Bangladesh stands at a critical crossroads. The country has made significant progress in expanding cancer care, but AMR is quietly eroding those gains. If action is not taken now, patients may survive cancer only to die from infections that can no longer be treated.

References:

1. WHO (February 3, 2025). Cancer.

2. Institute for Health Metrics and Evaluation (n.d.). The burden of antimicrobial resistance (AMR) in Bangladesh.

3. Cancer Medicine (December 13, 2024). Burden of Antimicrobial Resistance in Adult Hospitalized Patients With Cancer: A Multicenter Analysis.

The author is a research assistant at the Department of Microbiology and Hygiene, Bangladesh Agricultural University (BAU), Mymensingh, Bangladesh, and a former campus ambassador for The Daily Star from BAU.