October 24, 2024, 8:39 am | Read time: 5 minutes

Antibiotic resistance means that bacterial pathogens do not react to the drugs used to combat them. This can be fatal in the case of serious infections. It is already a fact that antibiotic resistance is an increasing global threat. And a recent study shows just how serious this is.

Study expects 39 million deaths due to antibiotic resistance soon

An international team of researchers led by Dr. Mohsen Naghavi from the Institute for Health Metrics and Evaluation (IHME) in Washington has investigated the potential impact of antibiotic resistance – abbreviated as AMR in the paper – around the world. Information on this is published in a press release.²

“Between 1990 and 2021, more than one million people worldwide died from AMR each year,” it says. And: “Future projections show that the number of deaths from AMR will rise steadily in the coming decades.” Specifically, the authors of the study expect an increase of around 70 percent by 2022. This would mean around 39 million deaths by 2050.

Details of the study

The study draws on over 520 million health data records from 204 countries. According to the publication, this came from a variety of sources, including hospitals, treatment protocols, and death registers. The survey period was from 1990 to 2021. It is reported that, in each of these 30 years, over one million people globally have died due to antibiotic resistance—alarming figures. The aim of the study was to assess the expected development.

The team built upon previous research. Its current study was carried out as part of the international research project “Global Research on Antimicrobial Resistance (GRAM).” It is related to a first study published in 2022.³ At that time, the researchers responsible for the study found that AMR had claimed more victims than HIV/AIDS or malaria, with 1.2 million deaths worldwide in 2019. Resistant bacteria are said to have at least indirectly contributed to a further 4.95 million deaths.

Procedure

The latest study is the first to forecast the global health impact of AMR up to the year 2050 and for 204 countries. The researchers concentrated on 22 recognized bacterial pathogens and 84 potential pathogen-drug combinations. They examined eleven infectious diseases in people of all age groups and used statistical models to assess how many of the deaths were directly attributable to antibiotic resistance and in how many of these deaths antibiotic resistance had at least played a role. On this basis and taking into account historical trends – for example, the number of AMR deaths in 2021 was lower than in 2019, which is likely to be related to the overall reduction in the number of bacterial infectious diseases due to corona-related contact restrictions – they extrapolated the development for the current years (starting in 2022) up to 2050.

Among the findings that the researchers gained from the analysis was a striking age shift in deaths caused by common diseases worldwide. For example, fewer deaths in childhood were documented overall. This can be explained by improved preventive measures (e.g., vaccination programs) for infants and young children. However, the number of infectious deaths in infants caused specifically by antibiotic resistance increased. At the same time, there was an even greater increase in AMR deaths among older adults (aged 70 and over). In this case by around 80 percent.

The researchers conclude that although infections in children have fortunately become rarer, on the negative side, they are more difficult to treat. “In addition, the threat of AMR to older people will continue to increase as the population ages,” the press release states. This appears to be due to the rapid aging of the population and the increased vulnerability of older individuals to infections.

Significance of the study on antibiotic resistance

To halt the anticipated progression, it is crucial to implement targeted measures promptly. In this context, investments in new, improved medicines and more extensive, intensive research would be conceivable. In principle, improved infection prevention would make sense; in this case, compliance with hygiene measures would be necessary, especially in hospitals and care facilities. Optimized diagnostic procedures could help to find the right antibiotic for an infection more quickly. This would mean that patients would not first have to try potentially unsuitable ones and then switch if necessary, which is known to promote the development of antibiotic resistance.

Most importantly, educating the public on the proper use of existing medications is essential. Conversely, a report from the past shows how the misuse of antibiotics has promoted devastating development.⁴ The data collection at the time focused on deaths caused by antibiotic resistance, especially in Europe. Among other things, it showed that many Europeans had taken antibiotics without any reason or for the wrong reason – for example, at the first symptoms of illness or against viral infections such as influenza or coronavirus. Antibiotics are not effective against viruses.

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Limitations of the study

The study authors acknowledge certain limitations of the results. For instance, data availability was limited for low- and middle-income countries. In order to be able to make estimates for them, investments would have to be made in the medical infrastructure. Furthermore, errors or distortions in data from some of the countries studied in particular cannot be ruled out. And finally, there was a lack of reliable data on antibiotic resistance for the years before 2000. This could have compromised the accuracy of the historical estimates within the study.