The bacteria we have spent 80 years fighting are learning to survive our best medicines, and we are running out of new ones.
Chart 1 of 5
Antibiotic approvals fell from 29 per decade in the 1980s to just four between 2020 and 2024. Early-stage trials are recovering, but almost none are making it through to patients. In 2022 only four novel candidates reached late-stage trials. Can we catch up in time before it’s too late?
A pipeline running dry
New antibiotic approvals per decade, and the drugs in development today
Approvals per decade
Novel candidates in the pipeline, by phase
Chart 2 of 5
Antimicrobial resistance was directly responsible for 1.14 million deaths globally in 2021. By 2050 that rises to 1.91 million per year with deaths among people aged 70 and over projected to more than double.
The pandemic we keep ignoring
Global deaths attributable to AMR by age group (thousands), 1990–2050
Chart 3 of 5
Across six key pathogen–antibiotic combinations, antibiotic resistance has risen in nearly every case since 2015. VRE peaked at 52.4% in 2015, fell but is climbing again. H. influenzae ampicillin resistance surged to 42.7% in 2024 alone.
Resistance is gaining ground
Share of tested isolates resistant to key antibiotics, Australia, 2015–2024
Chart 4 of 5
Only 45% of post-surgical prophylactic antibiotics in Australia are appropriate, that means more than half are unnecessary. In aged care, just 56.8% of prescriptions have a review or stop date, against the 95% target for best practise. Every inappropriate prescription accelerates antimicrobial resistance.
Where prescribing falls short
Share of prescriptions judged appropriate, by clinical setting, Australia
Hospital Aged care Surgical
Chart 5 of 5
Every year, millions of Australians undergo procedures that are only safe because antibiotics work. However, as antibiotic resistance rises, these procedures are becoming more dangerous.
What we stand to lose
Annual Australian procedure volumes that depend on working antibiotics
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Australian Commission on Safety and Quality in Health Care. (2024). Australian Passive AMR Surveillance An update of resistance trends in multidrug-resistant organisms -2006 to 2023. https://www.safetyandquality.gov.au/sites/default/files/2024-07/apas_report_-_multidrug-resistant_organisms.pdf
Australian Institute of Health and Welfare. (2025). Admitted patient care. Aihw.gov.au. https://www.aihw.gov.au/hospitals/topics/admitted-patient-care
Butler, M. S., Henderson, I. R., Capon, R. J., & Mark. (2023). Antibiotics in the clinical pipeline as of December 2022. The Journal of Antibiotics, 76. https://doi.org/10.1038/s41429-023-00629-8
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Sullivan, C., Fisher, C. R., & Taenzer, J. (2024, November). Novel Antimicrobial Drug Development and Access: U.S. Government Support and Opportunities. Nih.gov; Office of the Assistant Secretary for Planning and Evaluation (ASPE). https://www.ncbi.nlm.nih.gov/books/NBK611093/
World Health Organization. (2024a). Antibacterial products in clinical development for priority pathogens (Jun 2024). Who.int. https://www.who.int/observatories/global-observatory-on-health-research-and-development/monitoring/antibacterial-products-in-clinical-development-for-priority-pathogens-(jun-2024)
World Health Organization. (2024b, May 17). WHO bacterial priority pathogens list, 2024: Bacterial pathogens of public health importance to guide research, development and strategies to prevent and control antimicrobial resistance. Www.who.int. https://www.who.int/publications/i/item/9789240093461