Deaths From Drug-Resistant Infections Set to Spike by 2050, New Report Warns

Lack of prevention strategies and new drug development along with overuse of antibiotics are factors in the rise of antibiotic-resistant pathogens

Bottles of antibiotics line a shelf at a Publix Supermarket pharmacy in Miami on Aug. 7, 2007. Joe Raedle/Getty Images

In a forecast that threatens to unravel decades of medical progress, a new global study predicts that antibiotic-resistant infections could claim more than 39 million lives by 2050, potentially plunging the world into a post-antibiotic era.

The report, released by the Global Research on Antimicrobial Resistance (GRAM) Project, paints a picture of a looming public health crisis in which once-treatable diseases may again become deadly.

A Growing Global Threat

The GRAM report, published in The Lancet and presented at a global health summit in Geneva, Switzerland, shows a trend: Deaths attributed to antibiotic-resistant infections are projected to increase to 1.91 million in 2050 from approximately 1.14 million in 2021. To “die as a direct result of” implies a clear causal link, indicating that the death occurred specifically because of the resistant bacteria, without any intervening factors involved.

“Antimicrobial medicines are one of the cornerstones of modern healthcare, and increasing resistance to them is a major cause for concern,” study author Dr. Mohsen Naghavi said in a statement.

Naghavi is also a professor of health metrics sciences and team leader of the AMR Research Team at the Institute of Health Metrics, University of Washington.

The findings highlight that antimicrobial resistance (AMR) has been a significant global health threat for decades and that this threat is growing.

“Understanding how trends in AMR deaths have changed over time, and how they are likely to shift in the future, is vital to make informed decisions to help save lives,” he said.

Demographic Shift in Antibiotic Resistance

The report highlights a demographic shift. While mortality rates from antibiotic-resistant infections among children younger than 5 have declined, older adults are increasingly contracting more superbugs. The older adult population, particularly those with multiple underlying health conditions, is at heightened risk as antibiotic efficacy wanes.

However, while seniors are anticipated to be the most affected, the problem of AMR affects everyone, Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, told The Epoch Times.

“It has a trickle-down effect to all of our patients,” she said. “Don’t make the mistake that this is an elderly population issue— it’s actually not—it crosses all the ages.”

Factors Fueling the Rise of Antibiotic-Resistant Pathogens

Health authorities attribute the rise of antibiotic-resistant pathogens to several interlinked factors:

• Overuse of antibiotics in both human and veterinary medicine
• Inadequate infection prevention strategies
• Lack of new drug development

Globally, many countries continue to prescribe antibiotics unnecessarily for viral infections, such as colds and flu, further exacerbating the problem.

A study published in 2022 warned that antibiotic resistance is one of the most pressing global health challenges of our time.

“Antibiotic resistance appears inevitable, and there is a continuous lack of interest in investing in new antibiotic research by pharmaceutical industries,” the authors wrote.

According to Nachman, three key factors are driving the AMR crisis:

1. Age: As people get older, they tend to be prescribed more antibiotics.
2. Comorbidities: Older people often have multiple health conditions, leading to more doctor visits and a higher likelihood of receiving antibiotics from different providers.
3. Overreliance on emergency and walk-in care

“Far too often, before, during, and after COVID, we’re seeing doctors saying, ‘If you’re sick, go to the emergency room, go to a walk-in center,’” Nachman said.

These facilities, unfamiliar with a patient’s history, are more likely to prescribe antibiotics unnecessarily, she noted.

“You know, it sounds silly,” she said. “But stand outside an urgent care center and see how many people come out with prescriptions for antibiotics. It can’t be they all need them. So it’s an age factor, it’s a comorbidity factor, and it’s a misuse factor.”

The Consequences of Inaction

Increasing the number of antibiotic-resistant pathogens could severely reduce treatment options, Nachman said.

“You’re going to come to the hospital, have a multidrug-resistant pathogen, and I won’t be able to treat it,” she said. “And that harkens back to the days where we didn’t have meds. You came in septic, we identified your pathogen, and I could do nothing to make you better.”

A collaborative approach involving governments, health care providers, and the global community is essential to curtailing the spread of resistant pathogens, according to the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria.

While some countries have implemented robust antibiotic stewardship programs to combat overprescribing, the GRAM report highlights that these initiatives are inconsistent globally. In many regions, public awareness about the dangers of antibiotic misuse remains alarmingly low. Health advocates stress the need for comprehensive education campaigns to promote responsible antibiotic use.

Economic Implications of AMR

The urgency of the situation is further underscored by the economic implications of rising antibiotic resistance. A report from Pew Charitable Trusts estimated that the cumulative economic burden of antibiotic resistance could reach around $100 trillion by 2050 if left unchecked. As health care costs rise and productivity declines because of increased infection rates, the ripple effects could affect national economies across the globe.

In response to these trends, scientists are working on solutions, including the development of new antibiotics, bacteriophage therapy (a type of treatment that uses viruses to specifically target and kill bacteria), and other alternative treatments.

Better International Communication Helps Address Issue

Increasing urgency surrounding AMR is partly due to how much better treatment-resistant pathogens are being tracked internationally, Nachman said. In the past, if a country had an issue with an antibiotic, “it was like, ‘Oh, under the rug, don’t talk about it, whistle in the dark, it’s not here.’”

Now, with better communication across countries and health departments, there’s a clearer global picture of AMR, Nachman said.

“So we have a better sense of, OK, this country is seeing resistance to X. If you’re coming back from that country, you’re not going to get antibiotic X,” she said. “Because you came back from there and that’s what you came back with and it’s not going to work, we’re going to go for something different.”

Nachman also emphasized how important it is for patients to tell health care providers where they’ve been, what antibiotics they recently received, what they’ve been doing, and what other medications they’re using.

What We Can Do

Nachman said the first way to slow AMR resistance is just “simple, judicious use of antibiotics.”

“Just because you come in and have a fever or feel sick doesn’t mean you warrant an antibiotic,” she said. ”A case in point recently is a personal one, my daughter-in-law was pregnant, had a sore throat, went to an urgent care. They swabbed her, said her throat culture is negative, but here’s an antibiotic. Well, no, if your throat culture is negative, you don’t get an antibiotic.

“All year long, we see multitudes of respiratory pathogens. And we know that antibiotics will not help you if you get a respiratory viral pathogen—you won’t get better. We’re still seeing loads of patients that have RSV or flu, or even COVID getting an antibiotic when actually that’s not going to make them better faster.”

Nachman also warned against “antibiotic shopping”—the practice of visiting multiple urgent care centers until receiving an antibiotic prescription. This behavior, sometimes influenced by medical dramas on television, she noted, significantly contributes to the AMR problem.

“Unfortunately, that is really a huge part of our problem, and you know is it made worse by television and people seeing someone had rare disease X on a doctor show, and then they got antibiotic Y,” she said. “You know that’s television. What makes good television and what makes good care is really different.”

Better Health Care Access May Help Slow AMR

Better health care access is crucial in addressing antibiotic-resistant diseases, according to Nachman.

First, she recommends foregoing the urgent care center or walk-in center and to instead see your regular doctor.

“He or she should know who you are, what meds you’ve been on recently, and be sensitive to the fact that just because you’re sick doesn’t mean an antibiotic is going to make you better,” Nachman said.

Secondly, she said there is a need for better, more targeted, specific antibiotics, with a particular need for antibiotics against methicillin-resistant Staphylococcus aureus (MRSA), which have been increasing rapidly in the United States.

“It’s in the community. It is not a hospital pathogen, unlike what people thought in the past, ‘Oh my God, you got it in the hospital.’ No, it’s in our community,” Nachman said. “With a skin infection you get a typical antibiotic, but if you have an MRSA and I didn’t test you for it, well now you’re going to build up even more resistance.”

There is also a need for better outpatient and inpatient MRSA coverage that is not something like the drug vancomycin, which needs to get trough values (lowest concentration of the drug in the bloodstream) and can be toxic to kidneys, she noted.

For patients with multiple comorbidities, we need antibiotics that don’t interact with their other medications, according to Nachman.

“The long and short of it is that, yes, we do need discovery,” she said. “We do need more and better and different antibiotics, but we also need to be very smart about the use of the current ones we have and not just willy-nilly keep throwing them at patients.”