More than 1.2 million – and potentially millions more – died in 2019 as a direct result of antibiotic-resistant bacterial infections, according to the most comprehensive estimate to date of the global impact of antimicrobial resistance (AMR).

“These new data reveal the true scale of antimicrobial resistance worldwide, and are a clear signal that we must act now to combat the threat,” said the report’s co-author Prof Chris Murray, of the Institute for Health Metrics and Evaluation at the University of Washington.

The new Global Research on Antimicrobial Resistance (Gram) report estimates deaths linked to 23 pathogens and 88 pathogen-drug combinations across 204 countries and territories in 2019.

The analysis shows AMR was directly responsible for an estimated 1.27million deaths worldwide, and associated with an estimated 4.95 million deaths, in 2019.

Regionally, deaths caused directly by AMR were estimated to be highest in sub-Saharan Africa and south Asia, at 24 deaths per 100,000 population and 22 deaths per 100,000 population respectively.

In high-income countries, AMR led directly to 13 deaths per 100,000 and was associated with 56 deaths per 100,000.