This document discusses the future impacts of antibiotic resistance if it is not addressed. It notes that antibiotic resistance could lead to 10 million deaths per year by 2050 and cost the global economy billions. The world may enter a post-antibiotic era where common infections become difficult to treat again. Many drugs will become ineffective as resistance spreads, and new resistance mechanisms may emerge. Medical procedures could become more dangerous without effective antibiotics to treat associated infections. The costs of antibiotic resistance will be high both in terms of health and economic impacts. Urgent changes are needed in antibiotic use and development to address this growing threat.

1. Future impacts of
antibiotic resistance

2. Why does this matter?
 Antibiotic resistance does not only influence health in
the global population at present, but has the potential
to cause devastating worldwide consequences in the
future
 Recognition of these possible future impacts helps to
emphasise the need for drastic change in the
prescription and usage of antibiotics

3. Retrieved from: https://www.liveoakacupuncture.com/are-we-headed-for-a-post-antibiotic-era/

4. Retrieved from: http://www.businessinsider.com.au/how-common-will-antibiotic-resistant-infections-be-in-the-
future-2015-6?r=US&IR=T

5. Post-antibiotic era
 It is estimated that if antibiotic resistance is not tackled,
10 million people could die per year of curable
diseases by 20501
 The economy could lose billions of dollars more per
year due to increased loss of public health goods as
well as the huge costs associated with dealing with this
issue
 The world may enter a post-antibiotic era, whereby
previously treatable infections and injuries can become
deadly once more2

6. Retrieved from: http://www.slideshare.net/FranciscoIglesias10/neem-summary-report-2015-oct-final

7. Treatment failures
 Many drugs, after development, had negligible or very
low failure rates and generally succeeded in curing
various life-threatening diseases2
 With the emergence of antibiotic resistance, patients
worldwide have failed to respond to previously effective
antibiotic treatments2
 This includes the emergence of multidrug-resistant
tuberculosis, Plasmodium falciparum, methicillin-
resistant Staphylococcus aureus (MRSA) and so on3
 Drugs such as fluoroquinolones, carbapanems,
cephalosporins and so on are now ineffective in more
than half of people in countries all around the world2,3

8.  There has also been rapidly increasing resistance to drugs
used to treat tuberculosis, malaria, influenza, gonorrhea,
urinary tract infections and so on2
 With the rapid spread of antibiotic resistance, these
diseases will soon become extremely difficult to manage and
can cause increased disability and death2,3
 In terms of morbidity and mortality, diseases are expected to
vary across countries
 Malaria is expected to be the most significant in Asian
countries, while tuberculosis is expected to severely impact
Russia1

9. MRSA
 This is predicted to become a huge public health issue
 The scope of this resistance will extend to more settings –
hospitals used to be the only settings where MRSA was
found, but more community outbreaks can be expected4
 These outbreaks may happen in people who lack traditional
risk factors for MRSA4
 MRSA prevalence in the US community may reach 25% in
the next 10 years, with even higher rates within hospital
settings4

10. Loss of control over infection
 If antibiotic resistance continues, global health systems
will lose control over many infectious diseases
 The rates of hospitalisation and infection will be
elevated, and alternative treatments will need to be
sought
 Longer hospitalisation periods and greater extent of
disability3
 Death rates from infectious diseases will inevitably
increase

11. Resistance mechanisms
 There is the potential for new resistance mechanisms to
emerge, and for resistance rates as a whole to increase4
 Multiresistant streptococci, staphylococci and enterococci
will potentially cause substantial illness and be difficult to
combat, especially in parts of the world that have not yet
implemented strict control measures4
 Vancomycin-resistant antibiotics may become endemic on a
global scale4
 A huge number and range of antibiotics will be rendered
useless in the treatment of a large number of diseases

12. Development of antibiotics
 There have been no new antimicrobial classes developed for
gram-negative bacteria for decades4
 Vaccines have not been widely effective4
 Fluoroquinolones used to be widely effective against multiple
infections, but this is not the case anymore. There have also not
been any new class of antimicrobial agents to function as a
substitute for them4
 Several new antimicrobial drugs with different mechanisms of
action have failed in phase three trials4
 Antibiotics are being rendered useless very quickly but no novel
antibiotics have been found to be successful – this is very
concerning and can have devastating implications for the health of
global populations

13. Medical procedures
 Antibiotics have commonly been used to treat infections that
appear secondary to procedures such as caesarean child
birth, organ transplants, chemotherapy and so on1,2
 With the growing resistance against antibiotics, these
procedures will be able to cause diseases which may soon
be rendered incurable1
 Therefore, these procedures can become much more
dangerous, and are expected to cause higher rates of
persistent infection and death1
 This will impact not only wealthier countries where such
procedures are common, but also middle income countries
that are trying to implement health systems1

14. Costs of antibiotic resistance
 There will be a significant loss of public health goods due to
antibiotics being rendered useless by growing resistance, and
substantial economic losses
 Patients infected with drug-resistant bacteria generally suffer from
longer-lasting and more severe infections, and as such require
extended hospitalisation and increased treatment and care
resources 2,4,5
 Broad-spectrum antibiotics are being used increasingly for
empirical therapy of many common infections – these agents are
often costlier, and have more toxicity towards protective microflora.
They are also occasionally less effective5
 Alternative therapies and treatments are required, and these can
be expensive to develop or implement

15.  Therefore, it can be seen that antibiotic resistance is a
pressing issue that can have severe, negative
consequences on numerous countries worldwide.
 It is essential to understand these impacts in order to
grasp the importance of changing attitudes towards
antibiotic development, prescription and usage.

16. References
1. Dovey D. If We Don’t Do Something About Antibiotic Resistance, 10 Million People Could Die
Each Year [Internet]. Medical Daily. 2015 [cited 4 April 2016]. Available from:
http://www.medicaldaily.com/antibiotic-resistance-will-kill-10-million-people-year-2050-report-
shows-grim-future-316730
2. WHO | WHO’s first global report on antibiotic resistance reveals serious, worldwide threat to
public health [Internet]. Who.int. 2016 [cited 4 April 2016]. Available from:
http://www.who.int/mediacentre/news/releases/2014/amr-report/en/
3. Antimicrobial resistance [Internet]. World Health Organization. 2016 [cited 4 April 2016].
Available from: http://www.who.int/mediacentre/factsheets/fs194/en/
4. Harbarth S, Samore M. Antimicrobial Resistance Determinants and Future Control. Emerg
Infect Dis. 2005;11(6):794-801.
5. Eliopoulos G, Cosgrove S, Carmeli Y. The Impact of Antimicrobial Resistance on Health and
Economic Outcomes. Clinical Infectious Diseases. 2003;36(11):1433-1437.