More than 39 million people worldwide could die directly from antibiotic-resistant infections over the next 25 years, according to a modeling study published Tuesday in The Lancetwho still believes it is possible to avoid this dark scenario.
Already recognised as a major health challenge, antibiotic resistance – when bacteria or other pathogens undergo changes that prevent them from responding to antimicrobial treatments – is expected to worsen.
For the first time, this study assesses the impact of antibiotic resistance over time and attempts to estimate its evolution.
Data from over 520 million people
From 1990 to 2021, more than a million people per year worldwide succumbed directly to antibiotic resistance, according to its authors. They looked at 22 pathogens, 84 combinations between pathogens and treatments, 11 infectious syndromes in people of all ages, from 204 countries and territories, using data from more than 520 million people.
Over the past three decades, deaths of children under five directly caused by antibiotic resistance have fallen by more than 50%, as infection prevention and control have improved among infants and young children.
Less frequent in these children, infections have however become more difficult to treat when they occur.
At the same time, deaths of adults aged 70 and over jumped by more than 80% over the period, with populations ageing rapidly and older people becoming more vulnerable to infections.
Carbapenem resistance has progressed the most
As for pathogens, deaths from methicillin-resistant Staphylococcus aureus (MRSA) have increased the most worldwide. For Gram-negative bacilli, resistance to carbapenems has increased the most. And in the coming decades, deaths from antibiotic resistance will increase further.
The number of direct deaths could reach 1.91 million per year worldwide by 2050, a jump of more than 67% compared to 2021, according to the researchers’ models. By the middle of this century, antibiotic resistance would play a larger role in 8.22 million deaths each year, an increase of 74.5% compared to 2021.
In total, between 2025 and 2050, antibiotic resistance could directly cause more than 39 million deaths worldwide and would be associated with 169 million deaths, scientists estimate. But less pessimistic scenarios are possible.
Improved treatment of infections and access to antibiotics could prevent 92 million deaths worldwide between 2025 and 2050, particularly in South Asia and sub-Saharan Africa, according to the authors of the study.