Updated global estimates published in the Lancet attribute 1.27 million deaths directly to antimicrobial resistance in 2023, a figure that has increased 15 percent in four years. The most dangerous resistant organisms include carbapenem-resistant Klebsiella pneumoniae, extensively drug-resistant tuberculosis, and the hospital-acquired pathogen Candida auris, which is resistant to all three classes of antifungal drugs in some strains.
The development pipeline for new antibiotics remains critically thin. Only six new antibiotic classes have been approved for clinical use in the past 30 years compared to dozens of breakthroughs in the previous three decades. Pharmaceutical companies have largely exited antibiotic development because the business model requires drugs be used sparingly to preserve effectiveness, generating revenues that cannot justify development costs. Legislative solutions including transferable exclusivity vouchers and market entry rewards are under congressional consideration.
