More than 39 million people around the world could die from antibiotic-resistant infections over the next 25 years, researchers have warned.

Analysis of trends by the Global Research on Antimicrobial Resistance (GRAM) Project showed that one million people died a year from resistant infections between 1990 and 2021.

Writing in The Lancet, they estimated that by 2050, this will have increased by 70% to 1.91 million.

Over the same period, the number of deaths in which antimicrobial resistant bacteria play a role will increase by almost 75% from 4.71 million to 8.22 million per year, they calculated.

Since 1990 deaths related to antimicrobial resistance among children under five years old have been falling, a trend that is predicted to continue.

But deaths in people aged 70 years and older have increased by more than 80% and will likely double by 2050.

The study looked at data for 22 pathogens, 84 pathogen-drug combinations, and 11 infectious conditions (including meningitis) among people of all ages in 204 countries and territories.

Deaths due to methicillin-resistant staphylococcus aureus (MRSA) increased the most around the world, leading directly to 130,000 deaths in 2021, more than double that seen in 1990.

Among gram-negative bacteria, resistance to carbapenems increased more than any other type of antibiotic, from 127,000 in 1990 to 216,000 in 2021, the team reported.

The prediction of future trends highlights a vital need for interventions around infection prevention, vaccination, minimising inappropriate antibiotic use, and research into new antibiotics.

Study author Dr Mohsen Naghavi, from the AMR Research Team at the Institute of Health Metrics, University of Washington said: ‘Antimicrobial medicines are one of the cornerstones of modern healthcare, and increasing resistance to them is a major cause for concern.

‘These findings highlight that AMR has been a significant global health threat for decades and that this threat is growing.’

Co-author Dr Kevin Ikuta from the University of California Los Angeles said: ‘The fall in deaths from sepsis and AMR 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.

‘Further, the threat to older people from AMR will only increase as populations age. Now is the time to act.’

Dr Colin Brown, deputy director at UK Health Security Agency responsible for antimicrobial resistance, said: ‘This report is another reminder that antibiotic resistance is a threat to all of us – not just in the future but now.

‘If more infections continue to become resistant to treatment, lives will continue to be lost and we need universal action to turn this tide.’

In a separate comment piece in The Lancet, Dr Norman van Rhijn, from the University of Manchester, warned that more attention was needed on fungal resistant disease.

‘Most people agree that resistant bacterial infections constitute a significant part of the AMR problem.

‘However, many drug resistance problems over the past decades have also been the result of invasive fungal diseases largely under recognised by scientists, governments, clinicians and pharmaceutical companies.

‘The threat of fungal pathogens and antifungal resistance, even though it is a growing global issue, is being left out of the debate.’

This article first appeared on our sister publication Pulse.