Antimicrobial Resistance, A Global Concern
The global rise in antimicrobial resistance (AMR) is one of the top global public health and development threats. During 2019, bacterial AMR was directly responsible for an estimated 1.27 million deaths and contributed to 4.95 million deaths globally.1 In addition to death and disability, AMR has significant economic costs. The World Bank estimates that AMR could result in $1 trillion (U.S. dollars) in additional health care costs by 2050, and $1 trillion to $3.4 trillion in gross domestic product (GDP) losses per year by 2030.1
The 2022 Global Antimicrobial Resistance and Use Surveillance System (GLASS) report highlights alarming resistance rates among prevalent bacterial pathogens. Two examples include:
- Seventy-six countries reported a median of 42% of E. coli bacteria resistant to third-generation cephalosporins, and 35% of Staphylococcus aureus bacteria resistant to methicillin.1 In Minnesota, 15% of Staphylococcus aureus cases were resistant to methicillin in 2022.2
- Drug resistance in tuberculosis (TB) is a major contributor to global antimicrobial resistance. Multidrug-resistant TB disease (MDR-TB) is caused by bacteria that does not respond to the most effective first-line TB drugs. MDR-TB can be treated with second-line drugs, but these are expensive and can be toxic. Globally, there were an estimated 450,000 cases of MDR-TB, up 3.1% compared to 2020. This is explained by an overall increase in TB incidence between 2020 and 2021, which is presumed to be due to an increase in TB detection as a result of the COVID-19 pandemic.3 In Minnesota, there were 23 cases of confirmed or presumed MDR-TB reported from 2018 to 2022.4
The severity of AMR’s impact is why we all need to do our part to prevent resistance and ensure antibiotics remain effective. To improve how we use antibiotics, remember to use them only when needed (O.W.N.). Other steps you can take to prevent AMR include:
- Prevent infections through handwashing, vaccination, and food safety.
- Ask your provider how you can get symptom relief without antibiotics.
- Properly dispose of unwanted medications at a medication take-back box. Do not throw them away or flush them down the toilet or drain.
- Never pressure your health care provider or veterinarian to prescribe antibiotics.
- Take antibiotics exactly as prescribed, never save antibiotics for the next time you get sick, and never take antibiotics prescribed for someone else.
1Antimicrobial resistance. (2023, November 21). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
2Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2022. (2024, April 10). Minnesota Department of Health. https://www.health.state.mn.us/diseases/reportable/dcn/sum22/index.html
32.3 Drug-resistant TB. (2022). World Health Organization. https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022/tb-disease-burden/2-3-drug-resistant-tb
4TB Statistics. (2024, October 16). Minnesota Department of Health. https://www.health.state.mn.us/diseases/tb/stats/index.html
Coordinated Global Action to Address AMR
Addressing AMR on a global scale requires a coordinated response among world leaders and organizations. Fortunately, several initiatives and high-level meetings have been put into action in the last decade.
The World Health Assembly adopted the Global Action Plan on Antimicrobial Resistance (GAP) in 2015. As of November 2023, 178 countries have developed an AMR national action plan aligned with the GAP. The GAP outlines five objectives:
- Improve awareness and understanding of antimicrobial resistance through effective communication, education, and training;
- Strengthen the knowledge and evidence base through surveillance and research;
- Reduce the incidence of infection through effective sanitation, hygiene, and infection prevention measures;
- Optimize the use of antimicrobial medicines in human and animal health; and
- Develop the economic case for sustainable investment that takes account of the needs of all countries and the need to increase investment in new medicines, diagnostic tools, vaccines, and other interventions.
The Global Antimicrobial Resistance and Use Surveillance System (GLASS) was launched by the World Health Organization in 2015 to support the second GAP objective to “strengthen the knowledge and evidence base through surveillance and research.” GLASS was the first global collaborative effort to standardize AMR surveillance. GLASS continues to incorporate data progressively from surveillance of AMR in humans, and surveillance of antimicrobial use, including AMR in the food chain and in the environment.
The United Nations General Assembly (UNGA) hosted the first high-level meeting on AMR in September 2016. At this meeting, Heads of State committed to taking a broad, coordinated approach to address the root causes of AMR across multiple sectors, especially human health, animal health, and agriculture. This was only the fourth time a health issue has been taken up by the UNGA. The second high-level meeting on AMR took place on Sept. 26, 2024, when global leaders committed to a clear set of targets and actions, including reducing the estimated 4.95 million deaths associated with bacterial AMR annually by 20% by 2030. Learn more at WHO: World leaders commit to decisive action on antimicrobial resistance.
 Want to learn more?
Read how CDC is helping countries around the world improve their abilities to detect and combat antimicrobial resistance in health care settings at CDC: About International Infection Control Branch - Antimicrobial Resistance.
Toxic Side Effects from TB Treatment
CDC Antimicrobial Resistance Threat Report
Dr. Dalene von Delft was a newly qualified doctor in South Africa when her dreams of becoming a pediatric surgeon were shattered. Dalene contracted MDR-TB. Treatment took 19 harrowing months.
Dalene had to inject toxic second-line antibiotics that can cause severe side effects. She took 30 pills a day— 24 for TB and six for the side effects of TB treatment. The treatment made her so ill that she started to go deaf. Dalene had to make potentially life-threatening decisions to stop treatment to preserve her hearing and career. She often listened to music, worried the songs would be the last she ever heard.
MDR-TB affects people in the United States and around the world. Dalene recovered due to a new treatment that was in development. She founded a campaign to help protect health care workers and medical students against work hazards. CDC continues to work to stop the spread of TB and protect the health of all people.
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Story provided in the Drug-Resistant Tuberculosis (TB) fact sheet of CDC’s 2019 Antibiotic Resistance Threats Report.
Global AMR resources
Webinars & podcasts
American Society of Health-System Pharmacists Webinar
Tuesday, Nov. 19, 2024 | noon-1 p.m. CT
Register: Penicillin Allergy De-labeling as a Tool for Inpatient Antimicrobial Stewardship: A Real-World Experience
(open to ASHP members only)
CDC and Federal Office of Rural Health Policy Webinar
Wednesday, Nov. 20, 2024 | 2-3 p.m. CT
Register: Implementation of Priority Core Elements in Critical Access Hospitals
American Society of Health-System Pharmacists Clinical Conversations Podcast
Thursday, Nov. 21, 2024
Listen: Be Antibiotics Aware: Management of Community-acquired Pneumonia in Hospitalized Adults
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