How Many People Die From Antibiotic Resistance?
Drug-resistant infections directly kill about 1.14 million people a year and play a part in 4.7 million deaths. The data, the worst bugs and 2050.
Picture a woman in her seventies admitted to hospital with what looks like an ordinary urinary infection. She is given the antibiotic that has worked for that kind of infection for decades. Two days later her fever is higher, not lower. The lab results come back: the bacteria in her blood shrug off the first drug, and the second, and most of the third. By the time doctors find something that works, the infection has spread and her kidneys are failing.
Nothing about that story is unusual any more. It plays out thousands of times a day, in hospitals in Lagos, Delhi, São Paulo and Birmingham. Every one of those deaths is folded into the global total ticking on our live death counter, usually recorded as sepsis, pneumonia or a urinary infection rather than as "antibiotic resistance". That is part of why the problem is so easy to overlook.
This article pulls together the best estimates of how many people antibiotic resistance kills, which bacteria do the most damage, where the burden falls and what the forecasts to 2050 look like.
The headline number
The most detailed study of the problem so far is the Global Research on Antimicrobial Resistance (GRAM) project, published in The Lancet in September 2024. It looked at 22 pathogens, 84 combinations of bug and drug, and 204 countries from 1990 to 2021.
It produced two numbers, and the difference between them matters:
- Attributable deaths are deaths that would not have happened if the infection had been drug-susceptible. These are deaths caused directly by resistance: about 1.14 million in 2021.
- Associated deaths are deaths in which a drug-resistant infection was involved, even if the person might have died from the infection anyway. That figure was about 4.71 million in 2021.
| Time period | Deaths directly caused by resistance | Deaths associated with resistance |
|---|---|---|
| Per year (2021) | ~1,140,000 | ~4,710,000 |
| Per month | ~95,000 | ~392,500 |
| Per week | ~21,900 | ~90,600 |
| Per day | ~3,120 | ~12,900 |
| Per hour | ~130 | ~538 |
| Per minute | ~2.2 | ~9 |
So, every minute, roughly two people die because the antibiotics that should have saved them no longer work. Over a full day, that is more than 3,000 people.
To put that in context, about 62 million people die each year from all causes, so resistance directly causes almost 2% of all deaths worldwide, and is involved in about 7.6%. That puts it in the same range as some of the best known killers on the site.
| Cause | Estimated deaths per year |
|---|---|
| Antibiotic resistance (associated) | ~4,710,000 |
| Tuberculosis (all forms) | ~1,250,000 |
| Antibiotic resistance (directly caused) | ~1,140,000 |
| Road injuries | ~1,190,000 |
| HIV/AIDS | ~630,000 |
| Malaria | ~597,000 |
Drug-resistant infections, by the direct measure alone, now kill about as many people as road crashes, and nearly twice as many as HIV.
Why the deaths hide inside other causes
When someone dies of a resistant infection, the death certificate rarely says "antimicrobial resistance". It says sepsis, pneumonia, a bloodstream infection or a complication after surgery. That is because resistance is not a disease in itself. It is a property of the bacteria causing the disease.
This is why the GRAM figures overlap heavily with other pages on this site. Many of the deaths counted in sepsis deaths per day and pneumonia deaths involve bacteria that were resistant to at least one first-choice drug.
| Type of infection (2019 study) | Deaths directly caused by resistance |
|---|---|
| Lower respiratory infections (pneumonia) | Over 400,000 |
| Bloodstream infections | About 370,000 |
| Intra-abdominal infections | About 210,000 |
| All other infections (urinary, bone, skin, brain, TB and more) | The remainder, under a quarter |
Together, those three infection types made up nearly four in five of all deaths directly caused by resistance in 2019. Lower respiratory infections dominate because they are so common. They are already among the leading causes of death worldwide, and when the bacteria behind them stop responding to standard antibiotics, the death rate climbs fast.
The six bacteria that do most of the killing
Six pathogens account for the majority of resistance deaths. An earlier Lancet study covering 2019 found that these six alone were behind about 929,000 deaths directly caused by resistance.
| Bacterium | What it usually causes | Why it is a problem |
|---|---|---|
| Escherichia coli (E. coli) | Urinary and bloodstream infections | Most common cause of resistance deaths in many countries |
| Staphylococcus aureus (including MRSA) | Skin, bone, bloodstream infections | MRSA deaths more than doubled between 1990 and 2021 |
| Klebsiella pneumoniae | Pneumonia, sepsis in newborns and hospital patients | Increasingly resistant to carbapenems, a last-line drug |
| Streptococcus pneumoniae | Pneumonia, meningitis | Vaccine-preventable in many cases |
| Acinetobacter baumannii | Hospital infections, especially in intensive care | Often resistant to almost every drug available |
| Pseudomonas aeruginosa | Lung and wound infections, hospital infections | Naturally hard to treat |
The one causing the most alarm is resistance to carbapenems, a class of antibiotics doctors hold back for the toughest infections. GRAM found that carbapenem resistance rose faster than any other type between 1990 and 2021. When a bug shrugs off carbapenems, doctors are left with older, more toxic drugs, or sometimes nothing at all.
Streptococcus pneumoniae also causes meningitis, which has its own page: how many people die from meningitis every year.
Who dies: a shift towards older people
One of the most striking findings in the 2024 study is how the age profile has changed.
| Age group | Change in resistance-attributable deaths, 1990 to 2021 |
|---|---|
| Children under 5 | Fell by more than 50% |
| Adults 70 and over | Rose by more than 80% |
Children's deaths have fallen thanks to better vaccines, cleaner water and better care for infections in infancy, which is also visible on our under-5 age group page. Meanwhile, the world is ageing. Older people get more infections, spend more time in hospital, and are more likely to pick up resistant bacteria there. They are also less able to survive several days on the wrong antibiotic.
That shift is expected to continue. The study projects that, by 2050, the biggest increase in deaths will be among people aged 70 and over.
Where the burden is highest
Resistance is a global problem, but the death rate is far from even. The highest rates are in sub-Saharan Africa and South Asia, where infection rates are high, access to the right second-line antibiotics is limited and laboratory testing is scarce.
| Region | Situation |
|---|---|
| Western sub-Saharan Africa | Highest death rate from resistance in the world |
| South Asia (India, Pakistan, Bangladesh) | Projected to have the most deaths of any region by 2050 |
| Latin America and the Caribbean | Large projected rise by 2050 |
| Western Europe | Lower death rate, but rising carbapenem resistance |
| High-income North America | Lower rate, MRSA and C. difficile the main concerns |
A common misunderstanding is that resistance mainly kills in poorer countries because antibiotics are overused there. Overuse is part of the story everywhere, but so is the opposite problem: in many low-income countries, more people die from lack of access to antibiotics than from resistance. Both problems sit side by side.
Resistance in the UK and the US
United Kingdom
The UK Health Security Agency (UKHSA) publishes an annual report on resistance in England. Its latest estimates put the number of serious antibiotic-resistant infections at around 66,700 in 2023, with around 2,400 deaths. That is roughly six to seven deaths a day in England alone. For the wider picture of how people die in Britain, see how many people die in the UK every day.
United States
The US Centers for Disease Control and Prevention (CDC) estimates more than 2.8 million antimicrobial-resistant infections a year, with more than 35,000 deaths. On top of that, Clostridioides difficile, a gut infection closely tied to antibiotic use, kills more than 12,000 Americans a year.
| Country | Resistant infections per year | Deaths per year | Deaths per day |
|---|---|---|---|
| United States | ~2,800,000 | ~35,000 | ~96 |
| United Kingdom (England) | ~66,700 | ~2,400 | ~6.5 |
These national figures use narrower definitions than the global GRAM study, so they are not directly comparable, but they show the scale even in countries with well-funded health systems.
How fast resistance is spreading
In October 2025 the World Health Organization published data from its global surveillance system covering more than 100 countries. It found that about one in six laboratory-confirmed bacterial infections in 2023 was resistant to antibiotic treatment. Resistance rose in more than 40% of the bug and drug combinations it tracks between 2018 and 2023, by around 5% to 15% a year.
| Indicator | Figure |
|---|---|
| Lab-confirmed infections resistant to treatment (2023) | About 1 in 6 |
| Bug and drug combinations where resistance rose, 2018 to 2023 | Over 40% |
| Typical annual rise in those combinations | 5% to 15% |
The problem is worst for bacteria that cause hospital infections and bloodstream infections, the same ones that kill the most.
The forecast to 2050
The 2024 GRAM study also ran forecasts. If current trends continue:
| Measure | 2021 | 2050 (projection) |
|---|---|---|
| Deaths directly caused by resistance | ~1.14 million | ~1.91 million |
| Deaths associated with resistance | ~4.71 million | ~8.22 million |
| Cumulative direct deaths, 2025 to 2050 | n/a | ~39 million |
| Cumulative associated deaths, 2025 to 2050 | n/a | ~169 million |
You may have seen the older, often-quoted claim that resistance will kill 10 million people a year by 2050. That came from the UK government's O'Neill Review in 2014, which was a deliberately rough scenario intended to grab attention. The newer research suggests a lower but still enormous toll, with nearly 2 million deaths directly caused by resistance each year by 2050, and over 8 million in which it plays a part.
The same study also found that better care for serious infections and better access to existing antibiotics could prevent around 92 million deaths between 2025 and 2050. In other words, much of this future is avoidable.
What actually drives resistance
Bacteria evolve. When an antibiotic kills most of the bacteria in an infection, any that happen to survive can multiply and pass on their resistance. The more antibiotics are used, and the more carelessly they are used, the faster this happens.
| Driver | How it speeds resistance |
|---|---|
| Unnecessary prescribing (e.g. for colds and flu) | Exposes bacteria to drugs when there is no benefit |
| Not finishing a course as prescribed | Can leave tougher bacteria behind |
| Antibiotics in farming | Large volumes used in livestock worldwide |
| Poor hygiene and sanitation | Lets resistant bacteria spread between people |
| Weak infection control in hospitals | Resistant bugs pass from patient to patient |
| Few new antibiotics in development | Fewer options when old drugs stop working |
Antibiotics do nothing against viruses. Colds, most sore throats, most coughs and flu are viral. Taking antibiotics for them does not help you, but it does give bacteria in your body a chance to adapt.
What you can do
Most of the solutions sit with governments, hospitals, drug companies and farming. But individuals have a part to play too.
- Do not ask for antibiotics for a cold or flu. Ask your doctor or pharmacist what will actually help.
- Take antibiotics exactly as prescribed, and never share them or save leftovers.
- Keep up to date with vaccines. Preventing infections in the first place means fewer antibiotics are needed. The pneumococcal and flu vaccines matter most for older adults.
- Wash your hands, especially in hospitals and care homes.
- Know the signs of sepsis and act quickly. Fast treatment is what saves lives when an infection turns serious.
If you want to see how the big risks in your own life compare, our risk calculator breaks them down by age and lifestyle.
The bottom line
Antibiotic resistance does not make headlines like a pandemic, because it kills quietly, one hospital bed at a time, under other names. But the numbers are stark: around 3,100 deaths directly caused by resistance every day, and nearly 13,000 a day in which it plays a part. Without action, those numbers are expected to rise by roughly 70% by 2050.
The good news is that this is one of the few major causes of death where the tools to slow it already exist: better prescribing, vaccines, clean water, infection control and investment in new drugs.
While you were reading
It takes about 12 minutes to read this article. In that time, around 26 people died because the antibiotics meant to save them no longer worked, and drug-resistant infections played a part in more than 100 deaths. Every one of them is part of the total on the live death counter, which keeps running whether we are watching or not.
Data sources: GBD 2021 Antimicrobial Resistance Collaborators, "Global burden of bacterial antimicrobial resistance 1990 to 2021: a systematic analysis with forecasts to 2050" (The Lancet, 2024); Antimicrobial Resistance Collaborators, "Global burden of bacterial antimicrobial resistance in 2019" (The Lancet, 2022); World Health Organization, Global Antibiotic Resistance Surveillance Report (2025); UK Health Security Agency, English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) report; US Centers for Disease Control and Prevention, Antibiotic Resistance Threats in the United States; Review on Antimicrobial Resistance (O'Neill, 2014). Figures are rounded, and daily, hourly and per-minute numbers are derived from annual estimates. Resistance deaths overlap with deaths counted under sepsis, pneumonia and other infections. This article is for general information only and is not medical advice.
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