Medicine Antibiotics crisis threatens to get worse according to data analysis

Researchers have presented a forecast on the future development of antibiotic resistance. Their conclusion: new strategies are urgently needed.

By 2050, more than 39 million people worldwide could die from infections with antibiotic-resistant germs, and such pathogens could at least play a role in a further 169 million deaths. This is the conclusion of a comprehensive study on antimicrobial agents.

A key reason for the increase in resistance is the excessive and inappropriate use of antibiotics in human and veterinary medicine. Any use can lead to the proliferation of resistant bacteria, as these then have a survival advantage.

Being able to assess future developments is crucial for life-saving countermeasures, said Mohsen Naghavi from the University of Washington, one of the first authors of the study.

Huge data analysis

The research team led by Christopher Murray from the University of Washington in Seattle used 520 million data sets to depict the development of antibiotic resistance in the period from 1990 to 2021 in a computer model. This was then used as the basis for a forecast for the coming years, which is presented in the specialist journal "The Lancet".

The researchers' model also showed a possible positive development: better treatment of serious infections and improved access to antibiotics could prevent 92 million deaths between 2025 and 2050.

Interaction with other causes

It is not easy to determine the extent of the problem with resistance: If, for example, complications arise from multi-resistant germs during the treatment of cancer, the cause of a patient's death is nevertheless usually attributed to cancer. The authors of the study used hospital discharge data, data on causes of death, resistance profiles of individual drugs, surveys on antibiotic use and numerous other sources to record the extent of resistance and develop the global model.

From 1990 to 2021, more than one million people worldwide died each year due to antimicrobial resistance. The total number rose slightly, from 1.06 million in 1990 to 1.14 million in 2021. If population growth is taken into account, the death rate per 100,000 people fell from 19.8 (1990) to 14.5 (2021).

Older people particularly affected

However, the trend varies greatly by age group: while the number of resistance-related deaths among children under the age of five has been reduced by 50 percent, the number among people aged 70 or over has risen by 80 percent.

With regard to young children, the researchers write: "A large part of this reduction is due to a decrease in drug-resistant Streptococcus pneumoniae and pathogens that are usually spread by fecal-oral transmission". Vaccination campaigns and improved hygienic conditions have contributed to this.

The researchers attribute the increase in cases in older people to the often lower effectiveness or intolerance of vaccines and medicines in older people as well as more underlying illnesses.

Because the population group of over-64-year-olds will grow the most in the coming years, resistance-related deaths could also increase overall by 2050 according to the model: from 1.14 million (2021) to 1.91 million (2050) per year. According to the model calculation, the number of deaths in which multi-resistant germs play a role could increase from 4.71 million to 8.22 million.

List of countermeasures

"To prevent this from becoming a deadly reality, we urgently need new strategies to reduce the risk of serious infections through vaccines, new drugs, improved healthcare, better access to existing antibiotics and guidance on how to use them most effectively," said study author Stein Emil Vollset from the Norwegian Institute of Public Health.

The antibiotic crisis does not only affect countries with a low or medium average income. The USA and Canada were among the five regions of the world where resistance-related deaths increased the most between 1990 and 2021. The other regions are tropical Latin America, West Africa, South Asia and Southeast Asia.

By 2050, the highest rates of increase are expected in South Asia (including India), Latin America and the Caribbean. "This data should drive investment and targeted action to tackle the growing challenge of antimicrobial resistance in all regions," emphasized Samuel Kariuki from the Kenya Medical Research Institute, who was not involved in the study.

SDA