‘Antibiotic resistance crisis’… 39 million deaths in 25 years?

The problem of ‘antibiotic resistance’, which threatens lives because antibiotics do not work due to overuse of antibiotics, is imminent. A study found that by 2050, more than 39 million people worldwide will die directly due to antibiotic resistance.

An international research team, including the University of Washington in the United States and the Norwegian Institute of Public Health, announced the results of an in-depth analysis of the impact of antimicrobial resistance (AMR) on 204 countries and regions around the world over time.

According to the research results, more than 1 million people died each year worldwide from 1990 to 2021 due to direct causes of antibiotic resistance. During this period, the AMR mortality rate in children under 5 years of age decreased by about 50%, while the AMR mortality rate in the elderly over 70 years of age increased by more than 80%. In particular, the number of deaths due to AMR, including the elderly, is expected to increase steadily over the next several decades, and the AMR mortality rate is expected to increase by about 70% in 2050 compared to 2022.

The research team predicted that the total number of deaths (deaths due to direct and indirect causes) caused by ‘AMR germs (bacteria)’ will increase by about 75% from about 4.71 million to about 8.22 million per year between 2025 and 2050. Study co-author Dr. Mohsen Naghavi (Director of the AMR Research Team at the Institute for Health Metrics and Research) at the University of Washington said, “We are concerned that about 39 million people will die directly due to antibiotic resistance and about 169 million people will die from indirect causes between 2025 and 2050.”

The research team, however, predicted that if thorough measures such as improving health services, expanding disease prevention and control (vaccination, minimizing inappropriate antibiotic use), and improving access to antibiotics (development of new antibiotics) are taken, about 92 million lives could be saved between 2025 and 2050. The research team said, “The results of this ‘Global Antimicrobial Resistance Research (GRAM) project’ are the first to analyze trends in antimicrobial resistance (AMR) over time globally.”

Dr. Naghavi said, “Antibiotics are one of the cornerstones of modern medicine. However, concerns about the increase in ‘antibiotic resistance’, where antibiotics are no longer effective, have emerged as a major threat.”

The first GRAM study, published in 2022, found that AMR-related deaths worldwide (in 2019) were greater than those caused by HIV/AIDS and malaria. In 2019, approximately 1.2 million people died directly due to antibiotic resistance, and approximately 4.95 million died indirectly.

The team analyzed 22 pathogens, 84 pathogen-drug combinations, and 11 infectious syndromes (meningitis, bloodstream infections, etc.) across people of all ages from 204 countries and regions. The estimates were based on 520 million individual records from a variety of sources, including hospital records, death records, and antibiotic use data.

“With the rapid aging of the population, we are concerned that AMR will pose a major threat to the elderly,” said study co-author Kevin Ikuta, associate professor of infectious disease at the University of California, Los Angeles (UCLA). The most serious antibiotic-resistant bacteria (bacteria) currently include Gram-negative bacteria and methicillin-resistant Staphylococcus aureus (MRSA). Regions where the problem of antibiotic resistance is particularly severe include parts of South Asia, sub-Saharan Africa, Southeast Asia, East Asia, and Oceania.

The results of this study (Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050) were published in the international academic journal The Lancet.