Without more stewardship, superbugs could kill thousands more Americans annually by 2050
- Without strides in fighting antibiotic resistance, superbugs could kill 2.4 million people in North America, Europe and Australia over the next three decades, a new Organisation for Economic Co-operation and Development report warns.
- Italy, Greece and Portugal face the highest mortality rates, while the U.S., Italy and France risk the highest absolute death rates, with nearly 30,000 antimicrobial resistance (AMR) deaths a year by 2050.
- Yet spending just $2 per person a year on measures like handwashing and more sensible prescribing could prevent three out of four of those deaths, according to OECD.
Each year, as many as 2 million Americans acquire antibiotic-resistant infections and 23,000 die from them, according to the Center for Disease Control and Prevention. Meanwhile, the rate of antibiotic-resistant infections in children rose 700% between 2007 and 2017.
A major cause of the problem is over-prescribing of antibiotics. According to a recent CDC-funded study, nearly half of patients who visit urgent care centers for antibiotic-inappropriate respiratory issues such as bronchitis or flu are prescribed antibiotics. Incorrect prescribing is also prevalent in emergency rooms, doctor offices and retail clinics.
Last year, the World Health Organization issued its first-ever list of super pathogens for which antibiotics are urgently needed due to their resistance to existing antibiotics. The list includes 12 families of bacteria ranked as critical, high or medium priority for antibacterial research. Among those ranked critical are Pseudomonas and various Enterobacteriaceae, including E. coli. OECD recommends a five-pronged approach to combat AMR: promoting better hygiene promotion, ending over-prescribing of antibiotics, testing patients quickly to determine if their infection is bacterial or viral, delaying antibiotic prescribing and mass media campaigns to raise awareness about the problem.
Such efforts could see strong return on investment. According to OECD, countries could recoup their costs within a year and wind up saving $4.8 billion annually.
The report notes some slowdown in average AMR growth, but says serious concerns remain. Among them is resistance to second- and third-line antibiotics, which is expected to be 70% higher in 2030 than in 2005. Resistance to third-line antibiotics in EU member countries will double during the same period, while resistance to second-line treatments such as third-generation cephalosporins and fluoroquinolones could rise in a majority of countries. Some countries are already seeing resistance to polymyxins, which are the last line of resistance.
"Despite projected reductions in average resistance in Canada, Japan and Mexico, no single country is projected to reduce resistance for all eight antibiotic-bacterium combinations," the report says. "Rather, some countries including Denmark, Iceland, Luxembourg and Slovenia, could see resistance in all eight antibiotic-bacterium combinations."
Some efforts are underway to improve the situation. Many hospitals have adopted antibiotic stewardship programs to reduce inappropriate use. And The Pew Charitable Trusts and biopharma company Achaogen recently announced an agreement to share data from Achaogen's discontinued LpxC inhibitor antibiotic research program on Pew's open access Shared Platform for Antibiotic Research and Knowledge.
SPARK launched in September to catalyze research on new types of antibiotics by making data available to the wider scientific community.