Antibiotic Resistant Infection Deaths on Track to Increase 70 Percent by 2050
- by Natasha Hobley
- Published
- Infections
A recent study projects that deaths around the world due to infections that are resistant to existing antibiotics could increase nearly 70 percent by 2050. These antibiotic-resistant “superbugs” are fueled by what is known as antimicrobial resistance (AMR) caused by overuse and misuse of antibiotics as well as over-sanitization efforts. The World Health Organization (WHO) has called AMR “one of the top global public health and development threats.” The study published in The Lancet last month states that from 2025 to 2050, the world could see more than 39 million deaths directly attributed to AMR.1
Research from the U.S. Centers of Disease Control and Prevention (CDC) and the Pew Charitable Trusts shows that nearly one in three antibiotics prescribed at outpatient facilities is unnecessary. Antibiotics are ineffective against viruses such as SARS-CoV-2 or the flu. Earlier this year, the WHO presented findings of “extensive overuse” of antibiotics during the peak years of the COVID-19 pandemic. Its data suggested that approximately 75 percent of patients were treated with antibiotics “just in case”, despite only eight percent of patients hospitalized with COVID having bacterial co-infections.2
Doctors Not Following Antibiotic Prescription Rules
Another study, which was published by Clinical Infectious Diseases in April 2024 examining the antibiotic prescribing behavior of doctors treating outpatients in the US. between 2017 and 2023, found that inappropriate antibiotic prescriptions temporarily decreased in March 2020 during the coronavirus pandemic but then increased over time.3 Researchers from the University of Michigan (U-M), Northwestern University, and the Boston Medical Center reported that overall, 60.6 million antibiotic prescriptions were dispensed nationwide during the five-year study period and about 27 percent of the conditions for which antibiotics were prescribed did not justify the doctors’ antibiotic prescriptions.4
The lead author, pediatrician Kao-Ping Chua, MD, was quoted as stating:
Our findings highlight the continued importance of quality improvement initiatives focused on preventing unnecessary antibiotic prescribing and antimicrobial resistance, which kills 48,000 Americans per year.4
Antibiotic Prescribing Largely Driven by Patient Satisfaction
According to a medical doctor writing for Pew Trusts, inappropriate prescribing of antibiotics is not driven by data. Reasons include patient satisfaction, time constraints, decision fatigue, and uncertain diagnoses.5
A JAMA Internal Medicine study analyzed over 8,000 appointments for patients with respiratory tract infections like the common cold. Authors of the study found that patients rated themselves happiest with their doctor’s visit when they received an antibiotic after seeking care, whether or not an antibiotic was an effective treatment for the illness.6
“It is very problematic because it creates an incentive for physicians to do things that are not medically necessary in order to drive up their satisfaction ratings,” stated Kathryn Martinez, PhD, MPH, a Cleveland Clinic internal medicine researcher.6
Antibiotics Can Be Drivers of Disease and Illness
In addition to increasing morbidity and mortality rates due to antibiotic resistance, antibiotics can cause unintended side effects. While antibiotics are lifesaving when used selectively, researchers maintain that inappropriate use of antibiotics can cause more harm than good by damaging the gut barrier and killing the good bacteria that helps our immune system function normally. A study published in September 2024 in Science found that even short-term antibiotic treatment in mice led to breakdown of the mucus barrier in the colon, causing penetration of bacteria into the mucus layer and inflammation in the intestine.
The study authors stated that the success of antibiotics over the past century and praising them as “miracle drugs” have led to their overuse in both agriculture and medicine. They cite that in addition to AMR, several chronic diseases such as diabetes, growth defects, and chronic inflammation have been linked in multiple studies to antibiotic use. According to the authors:
As antibiotics target microbes directly, it is widely assumed that the effects of antibiotics on the gut microbiota are the main drivers of disease.7
FDA Allows for Overuse of Antibiotics in Meat and Fish Industries
Another contributing source of antibiotic exposure is antibiotics given to cattle, pigs, and chicken raised for food consumption. Approximately two-thirds of antibiotics considered “medically important” sold in the United States go to meat production. These antibiotics are routinely fed to animals that aren’t even sick as a “preventative” approach that makes the meat cheaper. While the chicken industry is phasing out routine antibiotic use, the antibiotic use by the beef and pork producers reportedly is on the rise. Despite the U.S. Food and Drug Administration’s (FDA) awareness of the problem, the agency has not stepped up effective efforts to protect the public health given the widespread public health crisis of antibiotic resistant microbes.8
The FDA has also approved five different antibiotics for use in aquaculture or farmed fish hatcheries. Researchers found that a “massive and inappropriate use” of antibiotics to prevent disease in farmed fish only fueled the development of resistant bacteria potentially harming humans.9
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