Over a million people around the world died annually due to antibiotic resistance between 1990 and 2021, and more than 39 million could die from antibiotic-resistant infections over the next 25 years, according to a global analysis, published in The Lancet journal.
Future deaths from antibiotic resistance are estimated to be highest in South Asia -- including India, Pakistan and Bangladesh -- where a total of 11.8 million deaths directly due to it are forecast between 2025 and 2050, a collaboration of researchers forming the Global Research on Antimicrobial Resistance (GRAM) Project said.
Antibiotic, or antimicrobial, resistance is when drugs designed to kill infectious bacteria and fungi are rendered ineffective because the bugs have evolved and developed an ability to defeat these drugs.
The researchers said deaths due to antibiotic resistance will also be high in other parts of southern and eastern Asia and sub-Saharan Africa.
Further, trends between 1990 and 2021 suggested that among people aged 70 years and above, deaths caused by antibiotic resistance increased by more than 80 per cent, and will continue to affect older people more in the years to come, the authors said.
Over the same period, deaths due to antibiotic resistance among children aged under five years fell by more than 50 per cent, they found.
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"The fall in deaths from sepsis (a bloodstream infection) and antibiotic resistance among young children over the past three decades is an incredible achievement. However, these findings show that while infections have become less common in young children, they have become harder to treat when they occur," author Kevin Ikuta, an affiliate professor at the Institute of Health Metrics (IHME), University of Washington, US, one of the collaborators on the GRAM Project, said.
"Further, the threat to older people from antimicrobial resistance will only increase as populations age. Now is the time to act to protect people around the world from the threat posed by antimicrobial resistance," Ikuta said.
An improved access to health care and antibiotics could save a total of 92 million lives between 2025 and 2050, the authors estimated. The study is the first global analysis of antimicrobial resistance trends over time, they said.
An increasing resistance to antibiotics -- one of the "cornerstones of modern healthcare" -- is a major cause for concern and the findings highlighted the significance of the global health threat, according to author Mohsen Naghavi from the IHME.
"Understanding how trends in antimicrobial resistance deaths have changed over time, and how they are likely to shift in future, is vital to make informed decisions to help save lives," Naghavi said.
The analysis was based on data from 520 million people of all ages in 204 countries and territories, taken from a wide range of sources, including hospital and death records, and antibiotic use information.
The estimates produced are related to 22 disease-causing microbes (pathogens), 84 pathogen-drug combinations and 11 infectious symptoms such as bloodstream infections, the authors said.
In 2019, deaths related to antibiotic resistance were higher than those from HIV/AIDS or malaria, leading directly to 1.2 million deaths and playing a role in a further nearly five million deaths, according to the first study by the GRAM Project, published in 2022.