Rising Antibiotic Resistance Exacerbates UTI Crisis in Malawi

Recent research highlights a concerning rise in antibiotic resistance affecting the treatment of urinary tract infections (UTIs) among women in Malawi. A study conducted at Zomba Central Hospital revealed that nearly half (48.5%) of women presenting with UTI symptoms were infected with bacteria resistant to multiple antibiotics, complicating effective treatment. This resistance is significantly higher than the global and regional averages, which range from 14% to 30% among pregnant women.

The study, published in BMC Infectious Diseases, was carried out by researchers from Mzuzu University and underscores the alarming resistance rates to commonly prescribed antibiotics such as ampicillin (87% resistance) and ceftriaxone (77% resistance). Multi-drug resistant strains, including Serratia marcescens, were identified, showing complete resistance to several antibiotics and only moderate susceptibility to last-resort drugs like meropenem and amikacin. This scenario signals a looming threat for future treatment options.

Kumwenda, the study's lead investigator, emphasized that these findings reflect a broader public health issue driven by factors like poor hygiene, limited healthcare access, and the overuse of antibiotics without proper diagnostics. The high prevalence of UTIs among women of reproductive age, coupled with elevated resistance, calls for urgent re-evaluation of diagnostic and treatment protocols. It also underscores the necessity to incorporate hygiene education, review contraceptive practices, and enhance screening during antenatal visits.

Malawi faces a larger antimicrobial resistance crisis, with estimates indicating that over 15,700 deaths annually are linked to drug-resistant infections. Self-prescription, where antibiotics can be bought without a prescription in pharmacies, is a significant contributor to rising resistance. Experts advocate for stricter enforcement of prescription-only sales and the implementation of antibiotic stewardship programs, including prescribing guidelines, sensitivity testing, and regulations against over-the-counter antibiotic access.

Addressing resistant UTIs is crucial to prevent potentially life-threatening complications such as sepsis, especially in young women. Strengthening policies and healthcare practices is essential for curbing this emerging threat and safeguarding the effectiveness of existing antibiotics.

Source: https://medicalxpress.com/news/2025-05-drug-resistance-worsens-uti-crisis.html