ANTIBIOTIC RESISTANCE PATTERNS AND EMPIRICAL THERAPY OUTCOMES IN CLINICAL SPECIMENS FROM QUETTA, PAKISTAN: A CROSS-SECTIONAL SURVEILLANCE STUDY

Abstract

Background: Globally, antimicrobial resistance is a global threat, especially in developing countries like Pakistan, where AMR is rising because many are not able to afford proper treatment. This study analyzes a region surveillance with low data available, prevalence of bacterial pathogens, and antibiotic susceptibility in specimens from Quetta, Pakistan. Methods: A retrospective cross-sectional study was conducted in the tertiary care hospitals of Quetta from January to October 2025 total of 615 specimens were analyzed during our study, following CLSI and manufacturer guidelines for culture and sensitivity testing. R- Studio and SPSS were used for statistical analysis. Results: Among our study's total of 615 specimens, 36.0% have shown different microbial growth. The most common organism isolates were Pseudomonas aeruginosa (20.8%), Acinetobacter spp. (19.4%), Salmonella typhi (18.1%), and S. aureus (18.1%). The rate of antibiotic resistance was seen to increase in Pseudomonas aeruginosa and Acinetobacter spp., especially in 3rd-generation antibiotics, cephalosporins, and fluoroquinolones. E. coli has shown the highest sensitivity, 75.0% to Imipenem, Nitrofurantoin, and Amikacin. The success rate of empirical therapy was seen in 43.3% of cases and the mismatch rate was 56.7%, highlighting the limitations of current prescribing practices. Conclusion: Our study shows an increasing rate of AMR resistance among common pathogens in Quetta, and there is a vital need to develop a localized antibiogram and revisit empirical therapy protocols. This study also suggests working on antimicrobial stewardship and regional surveillance for a better understanding of clinical outcomes and mitigation of resistance.