Abstract

Mini Review

Global Burden and Future Outlook of Antimicrobial Resistance

Muhammad Ajmal Dina*, Muhammad Akram Bhutta and Syed Ahmed Zeshan

Published: 25 March, 2026 | Volume 9 - Issue 1 | Pages: 018-021

Antimicrobial resistance (AMR) is a serious global health crisis. It is getting worse every year. Low- and middle-income countries (LMICs) are the most affected. This is mainly because infectious diseases are very common there. Poor water, sanitation, and hygiene (WASH) systems make things worse. On top of that, vaccination rates in these countries remain very low. All these factors together make AMR a much bigger threat in LMICs than anywhere else.
The recent data showed that bacterial AMR was linked to about 4.95 million deaths worldwide, and 1.27 million of the deaths were directly attributable in 2019. Using information from the Global Burden of Diseases, Injuries and Risk Factors Study 2021. The GBD Antimicrobial Resistance Collaborators employed statistical modelling to evaluate AMR trends from 1990 to 2021 and to forecast the burden through 2050 across 204 nations and territories.
The results are concerning. AMR-related deaths have increased significantly. Older adults aged 70 and above are the most affected group. However, there is some good news too. Deaths among children under five have dropped by nearly 50%. This is a big achievement. Better infection prevention has played a major role in this. Vaccination programs have also made a real difference. Improved water and sanitation (WASH) initiatives have helped as well. These combined efforts have clearly saved many young lives.
Key pathogens contributing to AMR mortality include Klebsiella pneumoniae, Escherichia coli, Streptococcus pneumoniae and meticillin-resistant Staphylococcus aureus (MRSA). In the absence of improved interventions, deaths attributable to AMR are anticipated to rise to 1.91 million annually by 2050. It is important to strengthen infection prevention, surveillance, vaccination, and WASH with integrated One Health approaches to ease the future impact of AMR.

Read Full Article HTML DOI: 10.29328/journal.ijcmbt.1001035 Cite this Article Read Full Article PDF

Keywords:

Antimicrobial resistance; Global health burden; Infectious disease epidemiology; Antibiotic resistance; Global burden of disease study; Low- and middle-income countries; Antimicrobial stewardship; Public health policy

References

  1. Nwakoby I, Iheukwumere I, Iheukwumere C, Nwakoby N, Idigo M, Ike V. Antimicrobial Resistance: A Legal and Public Health Perspective. IPS Journal of Applied Microbiology and Biotechnology. 2025;4(4):230–6. Available from: https://doi.org/10.54117/ijamb.v4i4.96
  2. Kapatsa T, Lubanga AF, Bwanali AN, Harawa G, Mudenda S, Chipewa PC, et al. Behavioral and socio-economic determinants of antimicrobial resistance in sub-Saharan Africa: a systematic review. Infection and Drug Resistance. 2025:855–73. Available from: https://doi.org/10.2147/IDR.S503730
  3. Kumar D, Ghosh N, Matta G, Lahariya C. Role of Safe Water, Sanitation, Hygiene Practices for Child Health: A Review. Preventive Medicine: Research & Reviews. 2025;10;4103.. Available from: https://journals.lww.com/pmrr/fulltext/2025/07001/role_of_safe_water,_sanitation,_hygiene_practices.5.aspx
  4. Xu J, Liu J, Li X, Zhao L, Shen J, Xia X. Burden of bacterial antimicrobial resistance in China: a systematic analysis from 1990 to 2021 and projections to 2050. Journal of Advanced Research. 2026;81;809-822. Available from: https://doi.org/10.1016/j.jare.2025.06.021
  5. Monowar T, Ali MI, Alam NN, Jui FN, Al Gaddafi A. Antimicrobial Resistance Patterns Among Pediatric Clinical Isolates in Southern Bangladesh. Khulna City Medical College. 2025;3(2). Available from: https://kcmc.edu.bd/uploads/images/journal/Journal-06_1762666054.pdf
  6. Naghavi M, Vollset SE, Ikuta KS, Swetschinski LR, Gray AP, Wool EE, et al. Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050. The Lancet. 2024;404(10459):1199–226. Available from: https://pubmed.ncbi.nlm.nih.gov/39299261/
  7. Mestrovic T, Naghavi M, Aguilar GR, Weaver ND, Swetschinski LR, Wool EE, et al. The burden of bacterial antimicrobial resistance in the WHO Eastern Mediterranean Region 1990–2021: a cross-country systematic analysis with forecasts to 2050. The Lancet Public Health. 2025;10(11):e955–e70. Available from: https://doi.org/10.1016/s2468-2667(25)00201-4
  8. James R, Hardefeldt LY, Ierano C, Charani E, Dowson L, Elkins S, et al. Antimicrobial stewardship from a One Health perspective. Nature Reviews Microbiology. 2025:1–17. Available from: https://doi.org/10.1038/s41579-025-01233-3
  9. Zhang Q, Fang Z, Fang B, Zeng H, Xu J. Clinical Epidemiological Analysis of the Genotypic Spectrum and Mortality Risk in Carbapenem-Resistant Klebsiella pneumoniae (CRKP) Infections. Canadian Journal of Infectious Diseases and Medical Microbiology. 2026;2026(1):1529426. Available from: https://doi.org/10.1155/cjid/1529426
  10. Him RL, Sihota D, Harrison L, Dramowski A, Coffin SE, Hamer DH, et al. Strategies to reduce antimicrobial resistance in newborns in low-income and middle-income countries: a systematic review and meta-analysis. The Lancet Global Health. 2026;14(4):e524–e38. Available from: https://doi.org/10.1016/S2214-109X(25)00533-9
  11. da Silva ÓP, Parente de Sá Barreto Maia Leite D, Vieira da Silva V, Barbosa IC, Dos Santos SF, Rodrigues Barros M, et al. Staphylococcus aureus in commercial laying hens from Pernambuco, Brazil: detection of efflux pumps and β-lactam resistance genes. Brazilian Journal of Microbiology. 2026;57(1):16. Available from: https://doi.org/10.1007/s42770-025-01821-8
  12. Hinterwirth A, Chen C, Yan D, Zhong L, Zhou Z, Liu Y, et al. Co-selection of genetic antibiotic resistance in Streptococcus pneumoniae after repeated azithromycin mass drug administrations in Niger. Antimicrobial Agents and Chemotherapy. 2026;70(2):e01562–25. Available from: https://doi.org/10.1128/aac.01562-25
  13. Li J, Cheng F, Wei X, Bai Y, Wang Q, Li B, et al. Methicillin-resistant staphylococcus aureus (MRSA): Resistance, prevalence, and coping strategies. Antibiotics. 2025;14(8):771. Available from: https://doi.org/10.3390/antibiotics14080771
  14. Navidifar T, Zare Banadkouki A, Parvizi E, Mofid M, Golab N, Beig M, et al. Global prevalence of macrolide-resistant Staphylococcus spp.: a comprehensive systematic review and meta-analysis. Frontiers in Microbiology. 2025;16:1524452. Available from: https://doi.org/10.3389/fmicb.2025.1524452
  15. Napoleão TH, da Silva Lira TL, Pontual EV, Ferreira GRS, da Silva PM. Lectins as Natural Antibiofilm Agents in the Fight Against Antibiotic Resistance: A Review. Molecules. 2025;30(16):3395. Available from: https://doi.org/10.3390/molecules30163395
  16. Lewnard JA, Charani E, Gleason A, Hsu LY, Khan WA, Karkey A, et al. Burden of bacterial antimicrobial resistance in low-income and middle-income countries avertible by existing interventions: an evidence review and modelling analysis. The Lancet. 2024;403(10442):2439–54. Available from: https://doi.org/10.1016/s0140-6736(24)00862-6
  17. Craddock HA, Kearney A, Fitzpatrick F, Finn C, Pryce MT, Fitzgerald-Hughes D. The challenge of reducing antimicrobial resistance (AMR) across the one health landscape: Diverse perspectives on AMR risks and their mitigation in sinks, drains, and wastewater. Science of The Total Environment. 2025;992:179935. Available from: https://doi.org/10.1016/j.scitotenv.2025.179935
  18. Naylor NR, Hasso-Agopsowicz M, Kim C, Ma Y, Frost I, Abbas K, et al. The global economic burden of antibiotic-resistant infections and the potential impact of bacterial vaccines: a modelling study. BMJ Global Health. 2025;10(6). Available from: https://doi.org/10.1136/bmjgh-2024-016249

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