Professor Emeritus Usa Thisyakorn
MD
Dengue is more than a mosquito-borne disease; it drives unnecessary antibiotic use and fuels antimicrobial resistance. Preventing dengue is a critical step in protecting lives, health systems and the future effectiveness of life-saving medicines.
Dengue prevention is AMR prevention — every life saved today protects the medicines we all need tomorrow.
Link between AMR and dengue management
As the world marks World AMR Awareness Week, we are reminded that antimicrobial resistance (AMR) is not a distant threat; it is a present crisis. Drug-resistant infections are already responsible for 1.27 million deaths each year,1 and could rise to 10 million annually by 2050.2 Yet, one disease is often overlooked in this debate: dengue.
Dengue is viral, not bacterial — but its impact on AMR is real. In many endemic countries, patients with fever are routinely prescribed antibiotics ‘just in case.’ This practice is ineffective and dangerous. Every unnecessary dose fuels resistance, wasting medicines we can’t afford to lose.
Every unnecessary antibiotic prescribed for dengue is another step towards a future where these life-saving medicines no longer work. Dengue prevention is AMR prevention.
Dengue outbreaks overwhelm hospitals, creating fertile ground for resistant infections.
The burden extends beyond misuse
Dengue outbreaks overwhelm hospitals, creating fertile ground for resistant infection. Patients with severe dengue are especially vulnerable. Even more concerning, dengue is shifting from mainly paediatric cases to more adults.3 This is a double threat: adults face a higher risk of severe complications and are more likely to receive empirical antibiotics. With cases increasing eightfold in two decades,4 unchecked epidemics now accelerate the AMR crisis.
This is why dengue awareness matters for AMR. Preventing dengue reduces inappropriate antibiotic use. Better diagnostics ensure the right care, not unnecessary prescriptions. Vaccination and vector control ease pressure on health systems. Stronger surveillance allows us to fight both dengue and AMR with speed and precision.
Recognising dengue as part of AMR
The fight against AMR will not be won in laboratories alone. It will be won in communities, clinics and hospitals where daily choices shape outcomes. Recognising dengue as part of the AMR story is essential.
We call on governments, funders and policymakers to act now: invest in dengue prevention, expand vaccination, strengthen diagnostics and scale up community education. Protecting lives from dengue today will protect the power of antimicrobials for tomorrow.
[1] Global burden of bacterial AMR in 2019 (The Lancet, 2022)
[2] O’Neill Report on AMR, UK Government, 2016
[3] Wilder-Smith A. et al., Shifting dengue epidemiology, The Lancet Infectious Diseases, 2019
[4] WHO Dengue Factsheet, 2023
Dengue Project Banpong-Photharam
Faculty of Tropical Medicine, Mahidol University
420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
Tel. +668 9780 3205
