An estimated 100 Australians die every week from a superbug infection, with newborn babies and the critically ill being at greatest risk of the rapidly rising threat of antibiotic-resistant infections.
Infectious disease experts are urging the Australian government to adopt a Netflix-style subscription model for new antibiotics to combat the rising threat, ahead of a global superbug summit in Sydney this week.
Superbug deaths in Australia are expected to increase from 5200 to 10,000 in 2050. Globally, 10 million people could die annually from antimicrobial resistance (AMR) by 2050 if not addressed.
AMR occurs when bacteria, viruses, fungi and parasites no longer respond to antibiotics, making infections difficult, in some cases impossible, to treat.
Without effective antibiotics, common infections and minor injuries can become life-threatening, routine surgeries and procedures (such as caesarean sections, knee replacements and cancer care) can be too risky to perform, and increasing hospital-acquired infections can spread to the community.
For two years, Lyn Barker has been fighting a superbug infection called Carbapenem-resistant Gram-negative bacteria (CR-GNB).
It began as a “little pin prick of a callus” in her right foot, that grew to a wound the size of her oldest grandchild’s fist. The pain was excruciating, Barker, 68, said.
The intravenous antibiotics she needed were only available at The Alfred Hospital. The side effects were toxic, causing her to vomit throughout her treatment despite taking three types of antiemetics.
“It was really difficult, but I saved my foot,” said Barker, a retired midwife. “They had talked about amputation.
“I’m still trying to heal up the wound,” she said, wearing a moon boot to protect the fragile tissue.
On Wednesday, the Australian Centre for Disease Control (ACDC) warned that antimicrobial resistance is one of the most urgent public health threats facing Australia and the world.
Reports of critical antibiotic resistance in Australia increased by more than 25 per cent in 2024 (3389 compared to 2706 in 2023), and fewer than half of the antibiotics administered after surgery were appropriate.
Multidrug-resistant bacteria were present in 12.2 per cent of bloodstream infections in children (222 patients), the ACDC reported.
Paediatrician and infectious disease physician Associate Professor Phoebe Williams spends countless nights and weekends in neonatal intensive care units, scouring research papers for a Hail Mary combination of antibiotics to fight off a superbug attacking a premature baby.
Less than a decade ago, these cases were rare, Williams said. “Now we see them monthly, sometimes weekly.”
“Antimicrobial resistance [AMR] is evolving faster than we can come up with medications to treat these multidrug-resistant bugs,” Williams said. “But in children, the problem is exacerbated; we have even less access to new antibiotics that are only licensed [for] adult patients.
“A colleague of mine had to sneak some antibiotic from an adult pharmacy that we knew could work to treat a premature baby with a very bad infection, and without that antibiotic, that baby was going to die.”
Of the 25 novel antibiotics approved in the US and Europe since 2011, only three are registered for use in Australia, according to the Australian Antimicrobial Resistance Network (AAMRNet).
A recent analysis found that clinicians submitted 500 applications each month to access antibiotics not registered in Australia. One quarter (27 per cent) were for critically ill patients.
AAMRNet wants Australia to adopt an antimicrobial subscription model in which the federal government would pay pharmaceutical companies a fixed annual fee for access to novel antibiotics, regardless of their use, to incentivise these companies to invest in their research and development.
Under the UK’s subscription model, the NHS can pay £5 million ($9.6 million) to £20 million per drug per year. The scheme has secured access to two new antibiotics (Cefiderocol and Ceftazidime-avibactam) to treat severe, multidrug-resistant Gram-negative infections.
This “Netflix-style approach … addresses a market failure,” said Dame Professor Sally Davies, UK Special Envoy on AMR, who is in Sydney for the Global AMR Summit hosted by CSIRO and the UK Fleming Initiative and supported by GSK, which has a significant AMR medicines research and development pipeline.
“[Pharmaceutical companies] don’t make much of a profit on something that people only take once for a week once a year rather than something like a diabetic drug,” Davies said.
“We need big companies manufacturing new antibiotics. If we get this right and other countries join in, then it will reactivate the whole industry in this field.”
Williams said that a subscription model must be accompanied by rigorous stewardship to preserve the effectiveness of new antibiotics.
“If you do allow these novel antibiotics to be easily prescribed, then it only takes a year or two before the bugs are resistant to those,” she said.
A spokesperson for the Albanese government said it was committed to minimising AMR development and spread, and ensuring the continued availability of effective antimicrobials.
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