Antimicrobial drugs are widely used around the world to treat infections. However, the overuse of antimicrobials has resulted in antimicrobial resistance (AMR) that has led to the emergence of superbugs such as methicillin-resistant staphylococcus aureus (MRSA), Clostridium difficile, and bacteria causing multi-drug-resistant tuberculosis. Bacteria that are resistant to antimicrobials pose an important global health challenge. The study by GBD 2021 Antimicrobial Resistance Collaborators, published in The Lancet in September 2024, reported that by 2050, superbugs could directly cause 39 million deaths worldwide and be strongly associated with a further 169 million.
The study’s authors estimated all deaths attributable to bacterial AMR in 204 countries and territories from 1990 to 2021. They analysed causes of death using hospital discharge data, microbiology data, antibiotic use surveys, mortality surveillance and insurance claims data: 520 million individual records or isolates, and 19,513 study-location-years. Based on the data collected and analysed, the percentage of a given microorganism resistant to an antimicrobial and the excess risk of death associated with this resistance were calculated.
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The study reported that in 2021, 4.7 million deaths were associated with bacterial AMR. Long-term trends, however, showed that AMR mortality varied substantially from 1990 and 2021 by age and geographical location. Deaths due to AMR decreased by more than 50% in children younger than five, but increased by more than 80% in adults 70 and older, indicating the marked recent improvement in treatment offered to children. The high rate of death in the older group could be related to a rapidly ageing population and the presence of comorbid conditions, which increases the risk. The study also projected that most future deaths will occur in South Asia and Sub-Saharan Africa, based on the historical trend from 1990 to 2021.
Overprescription of antibiotics has increased drug resistance
Among the superbugs, deaths from MRSA have increased the most globally, rising from 261,000 associated deaths and 57,200 attributable deaths in 1990 to 550,000 associated and 130,000 attributable deaths in 2021. MRSA cases are rising globally and GlobalData epidemiologists forecast that hospitalised incident cases of MRSA will grow steadily in the seven major markets (7MM: France, Germany, Italy, Japan, Spain, the UK and the US), from 700,000 cases in 2023 to 800,000 cases in 2033 at an annual growth rate of 1%.
In recent years bacteria have evolved and antibiotics have been overprescribed to help fight different types of infections. This has gradually increased drug resistance and increased the risk of superbug infections. A significant proportion of drugs prescribed each year are unnecessary and add to AMR. To prevent the further increase of such cases, and the overall disease burden, there should be an improved focus on infection control, both in and out of healthcare settings, and practitioners should avoid overuse of antimicrobials where possible.
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