blog.macafrica.org

Antimicrobial Resistance (AMR): A Hidden Threat to Cancer Care

Move Against Cancer Africa | November 2025

Raphael, a 32-year-old man undergoing chemotherapy for lung cancer, develops what should have been a minor, easily treatable infection. But due to years of antibiotic misuse, the infection is drug-resistant. Standard treatments fail, his recovery slows, and the emotional and financial toll intensifies. This scenario reflects a growing, real threat: Antimicrobial Resistance (AMR) and its devastating impact on cancer care.

During this AMR Week, we join the global community to raise awareness about the silent crisis that undermines cancer treatment outcomes. For immunocompromised patients, even a single resistant infection can become life-threatening, turning hope into uncertainty.

The Growing AMR Crisis: Global to Nigerian Context

AMR causes an estimated 1.27 million deaths annually worldwide and continues to rise due to inappropriate antibiotic use, inadequate infection control, and weak regulation (WHO, 2023). In many African countries, limited access to diagnostics and widespread self-medication worsen the situation, with resistant pathogens responsible for up to half of all hospital-acquired infections (O’Neill, 2016; Laxminarayan et al., 2020).

In Nigeria, the situation is particularly alarming. Over-the-counter antibiotics, weak enforcement of policies, inadequate stewardship programmes, and poor infection prevention leave patients, especially those battling cancer, extremely vulnerable (Okeke et al., 2021). Drug-resistant infections delay chemotherapy cycles, prolong hospital stays, increase treatment costs, and significantly raise the risk of mortality.

Sign of Progress and Hope

Despite the growing burden of antimicrobial resistance, evidence from global cancer centres demonstrates that targeted interventions can significantly reduce resistant infections and improve outcomes for immunocompromised patients. Across high-income settings, oncology hospitals that have implemented comprehensive antimicrobial stewardship bundles, incorporating routine culture-guided therapy, rapid diagnostics, multidisciplinary antimicrobial review, and safe early de-escalation, have recorded reductions in mortality, shorter febrile neutropenia episodes, and fewer instances of inappropriate empirical antibiotic use (Gudiol et al., 2023).

Across Africa, antimicrobial stewardship (AMS) is expanding in hospitals despite resource constraints. Multifaceted interventions, including audit and feedback, education, and protocol development, reduce inappropriate antibiotic use and improve guideline adherence, though limited laboratory capacity and staffing remain barriers (Abubakar et al., 2022; Olumuyiwa et al., 2023). In oncology, antimicrobial resistance is particularly alarming, with high prevalence of resistant pathogens among cancer patients (Ntim et al., 2025). Diagnostic limitations, including scarce rapid molecular assays, hinder timely de-escalation and targeted therapy. In Nigeria, only 57% of healthcare professionals demonstrate adequate AMS knowledge (Akpan et al., 2024). These findings highlight the need for strengthened laboratory capacity, multidisciplinary training, and context-adapted AMS programs to protect vulnerable oncology patients.

Many countries in the Africa have developed national action plans. Several have national antimicrobial stewardship programmes that promote diagnostics-led decision-making, audit-and-feedback mechanisms, and clinician education. However, integration with oncology care remains limited. With coordinated leadership, improved diagnostic capacity and strengthened stewardship in oncology units, better outcomes for cancer patients are achievable.

Key challenges in African oncology care settings

These challenges require practical, coordinated actions that can be implemented immediately.

Recommendations

To safeguard cancer patients from drug-resistant infections, five priority strategies are essential:

Conclusion

For cancer patients, antimicrobial resistance impacts their survival. Strengthening stewardship, improving access to diagnostics, enhancing infection prevention, and empowering patients and the public with information can significantly reduce resistant infections and protect treatment outcomes.

MACA stands united with global efforts to raise awareness, advocate for stronger policies, and protect the lives of cancer patients during this World Antimicrobial Awareness Week. Cancer should never be a death sentence, and preventable infections should never steal the future of those fighting bravely.

#AMRWeek #CancerCare #PatientSafety #AMR #MACA #GlobalHealth #InfectionPrevention

Authors: Dr Abiodun Egwuenu, Mrs Ogechukwu Akabuike

References