Skip to Content

Consequences of Antimicrobial Misuse

According to the World Health Organization (WHO), there are no global data on the number of cases or fatalities due to highly resistant pathogens. These gaps in knowledge regarding the economic and human cost of resistant bacterial infections are due to the lack of any coordinated global surveillance system.

In the U.S. alone, superbugs affect more than 2 million individuals and contribute to 99,000 deaths each year.1 In the European Union, at least 25,000 patients die every year from multidrug-resistant pathogens2; two-thirds of these are due to gram-negatives. Once confined almost exclusively to the hospital environment, superbugs such as MRSA and Clostridium difficile are now emerging in the community setting.

Content produced by the Alliance for the Prudent Use of Antibiotics (APUA) through an unrestricted educational grant from Alere Inc.

More people now die each year of hospital acquired infections than of AIDS, traffics accidents and the flu combined.

- Center for Disease Dynamics, Economics and Policy (CDDEP)1

The Rise of the Superbug

As of 2011, the estimated annual sales of antimicrobials was ~36 million pounds (lbs.) in the US alone (28.9 million sold for animals and 7.3 million for treating sick people), 70% of which is not utilized for disease treatment, but rather for purposes of growth promotion and prophylaxis in farm food animals.3

This use, in conjunction with the major driving force of overuse and misuse in humans has given rise to an era of "superbugs" – organisms that are resistant not only to multiple drugs, but in some cases, to every, or all but one, "last resort" antibiotic (Fig. 1). Life-threatening, antibiotic-resistant infections have even forced a reversion to the use of older drugs that were largely abandoned because they were considered too toxic for regular use.

Emergence of resistance in hospital and community acquired pathogens

Fig. 1 Emergence of resistance in hospital and community acquired pathogens
MRSA: methicillin-resistant Staphylococcus aureus; VRSA: vancomycin-resistant S. aureus; ESBL+: extended-spectrum beta-lactamase producers; CRE: carbapenem-resistant Enterobacteriaceae; VRE: vancomycin-resistant enterococcus; MDR-TB: multi-drug resistant M. tuberculosis; XDR-TB: extensively drug-resistant M. tuberculosis; CA-MRSA: community-acquired methicillin-resistant S. aureus.

Source: adapted from Cohen, M. et al. (1992) Epidemiology of drug resistance: implications for a post-antimicrobial era. Science 257:1050-1055.

At What Cost?

In the U.S. alone, superbugs affect more than 2 million individuals and contribute to 99,000 deaths each year.1 In the European Union, at least 25,000 patients die every year from multidrug-resistant pathogens4; two-thirds of these are due to gram-negatives. 

The total medical and societal costs of treating these resistant infections have escalated dramatically and are now estimated at $16.6-26 billion in the U.S.3 and at least €9 billion in the EU.5 For Clostridium difficile infection alone, the annual excess hospital healthcare cost is estimated at $1.1 billion in the U.S. and €3 billion in the EU.6

Related Content

Antimicrobial Misuse and Resistance

Today's global crisis in antimicrobial resistance should never have come as a big surprise.

Learn more

Antimicrobial Stewardship Implementation

In its broader holistic sense, antibiotic stewardship is the careful and responsible management of antibiotic resources in the interest of long-term sustainability.

Learn More

The Health Provider’s Role in Antibiotic Stewardship: Confronting Global Antibiotic Resistance

Download the PDF