Antibiotic Resistance Market Size, Share & Trends Analysis Report By Disease (cUTI, CDI), By Pathogen, By Drug Class (Oxazolidinones, Lipoglycopeptides), By Mechanism Of Action, By Distribution Channel, By Region, And Segment Forecasts, 2023 - 2030

Report Overview

The global antibiotic resistance market size was valued at USD 8.13 billion in 2022 and is expected to grow at a compound annual growth rate (CAGR) of 5.7% from 2023 to 2030. The increasing burden of antibiotic-resistant infections across developed & developing regions and a shift in prescription patterns to newly launched therapies are the key drivers of the market. The WHO’s global antimicrobial surveillance system has revealed the occurrence of antibiotic-resistant infections among 500,000 people across 22 countries which mainly includes high-income & middle-income countries.

Moreover, the increasing involvement of government and non-government bodies in the development of novel therapies is anticipated to drive market growth. For instance, the WHO and other organizations are actively working on providing financial support to boost the drug development process.

The high burden of antibiotic-resistant infections is a major concern globally. According to the CDC, the incidence of antibiotic-resistant infections is more than 2.8 million in the U.S. The annual burden of the disease in the country is estimated between USD 21.0 billion to USD 34.0 billion. Globally, MRSA imposes a significant cost burden due to a high resistance rate of an average of 25.0% in developed countries and around 40% in developing regions. The pathogens such as Enterobacteriaceae, P. aeruginosa, K. pneumoniae, and others have a high resistance rate of an average of 40.0% in developed countries. WHO and CDC have identified these pathogens as a high priority, under the critical or urgent category due to their high incidence. These pathogens account for a major share of healthcare-associated infections. The excessive use of a broad spectrum of antibiotics in developing regions is increasing resistance rates.

Rising government and non-government initiatives to develop novel therapies to treat antibiotic resistance diseases are anticipated to propel market growth. To combat this increasing threat of antibiotic resistance, the U.S. government developed the National Strategy for Combating Antibiotic-Resistant Bacteria (CARB) for a five-year plan for the period of 2020 - 2025.

Strong pipeline products are expected to positively impact the market over the forecast period. Companies such as Melinta Therapeutics; Basilea Pharmaceutica Ltd.; Pfizer Inc.; and Merck & Co., Inc. have strong drug candidates in late clinical trial phases for the treatment of antibiotic-resistant diseases. For instance, Melinta Therapeutics has two drug candidates, solithromycin (pre-registration), and CEM-102 (phase 2) in late clinical trial phases and are expected to be commercialized over the forecast period.

Disease Insights

Based on disease, complicated urinary tract infections accounted for the largest share of 24.1% in the antibiotic resistance market in 2022 and are expected to maintain their dominance over the forecast period. cUTI, cIAI, and BSI held a majority of the share, of more than 60% of the total antibiotic resistance industry owing to a high number of gram-negative infections and the high cost of treatment. Furthermore, the presence of a strong product pipeline is expected to drive the cUTI market at a lucrative growth rate.

However, the clostridium difficile infections segment is growing at the fastest CAGR of 6.4% owing to the emergence of antibiotic-resistant infections and recurrent CDI. Moreover, the presence of the biologic, Zinplava, when used as part of combination therapy with Dificid also increases the treatment cost. Antibiotic-resistant CDI is more common in children, healthy peripartum women, and antibiotic-naive patients. According to the CDC, the incidence of Clostridium difficile infections in the United States is 223,900 per year, and the disease causes nearly 12,800 deaths.

With the growing need for efficacious drugs to combat antibiotic-resistant strains of C. difficile, several players are focusing on the development of novel compounds. Companies such as MGB Biopharma; Seres Therapeutics; and Summit Therapeutics have pipeline products targeting CDI infections. Seres Therapeutics’s SER-109 is in pre-registration. SER 109 has strong potential as the first microbiome therapeutic with breakthrough and orphan drug designations that will fast-track its development. The U.S. FDA has set a PDUFA date of April 2023.

Pathogen Insights

Enterobacteriaceae, P. aeruginosa, A. baumannii, and S. aureus held the majority of the share in 2022 due to the high resistance rate of these. The high burden of disease coupled with limited low-cost efficacious options is driving the shift toward new-generation antibiotics including Allergan’s Avycaz; Merck’s Zerbaxa; and Melinta Therapeutics’ Vabomere.

Enterobacteriaceae includes E. coli/K. pneumoniae which accounted for the largest share of more than 40.1% in 2022 in the antibiotic resistance market. According to CDC estimates, around 140,000 healthcare-associated Enterobacteriaceae infections occur every year, out of which, more than 9,000 are due to CRE. This includes about 7,900 by CR-Klebsiella spp and 1,400 by CR-E. Coli. Due to the extensive use of carbapenem in labs, CRE is growing at a fast pace.

The Clostridium difficile pathogen segment is anticipated to grow at the fastest growth rate followed by the P. aeruginosa segment. Dificid (macrolide) and Zinplava (bezlotoxomumab) are major drugs used to treat Clostridium difficile infections. However, P. aeruginosa strains are a cause of high morbidity and mortality with longer hospital stays and higher costs comxpared to those infections caused by susceptible strains. Infections due to drug-resistant P. aeruginosa account for approximately 15.0% of healthcare-associated infections annually. The treatment of P. aeruginosa infections involves ciprofloxacin, antipseudomonal penicillins, and cephalosporins.

Mechanism of Action Insights

The cell wall synthesis inhibitors segment was one of the most dominant segments with more than 30.0% share of the antibiotic resistance market in 2022. The dominance of this segment was majorly due to the broad spectrum of action exhibited by these antibiotics against both gram-positive and gram-negative bacteria and their widespread usage in medical practice contributes to the high prescription rates.

The RNA synthesis inhibitors segment is anticipated to grow at the fastest rate from 2022 to 2030 owing to its distinctive mode of action and its ability to disrupt bacterial RNA synthesis, which is crucial for protein production, and provides a unique approach to combating bacteria.

Distribution Channel Insights

Hospital pharmacies held the majority share of over 40% in 2022. Hospital pharmacies play a vital role in combating antibiotic resistance through the implementation of stewardship programs, managing drug formularies, monitoring resistance patterns, providing education, and ensuring medication safety. Antibiotic stewardship programs promote appropriate use of antibiotics by ensuring judicious prescribing, dosage selection, and treatment duration, which helps prevent the emergence and spread of antibiotic-resistant bacteria.

The online pharmacies segment is one of the fastest growing segments over the forecast period owing to the increasing adoption of telemedicine services, allowing patients to consult with healthcare professionals remotely. Also, online pharmacies offer convenient and regulated access to authorized antibiotics, ensuring that patients can obtain necessary medications with valid prescription. This helps prevent the misuse and availability of unregulated or counterfeit antibiotics, thereby mitigating the risk of antibiotic resistance.

Drug Class Insights

The combination therapies segment is expected to grow at the fastest rate of 8.6% from 2022 to 2030. High unmet needs due to growing resistance to antibiotics are the primary factor driving the adoption of combination therapies for the treatment of diseases. Combination therapies of beta-lactams and beta-lactamase inhibitors targeting both carbapenemases and ESBLs mediate strong activity against these resistant pathogens. Moreover, the growing burden of antibiotic-resistant Gram-negative infections is the prime force driving the penetration of new-generation combination therapies.

The Oxazolidinones segment accounted for a share of 13.9% in 2022 in the antibiotic resistance market and is anticipated to grow at a lucrative growth rate of 6.7% over the forecast period. Oxazolidinone is a novel class of antibiotics and exhibits strong activity against most types of Gram-positive bacteria including MRSA, vancomycin-resistant S. aureus, penicillin-resistant pneumococci, and vancomycin-resistant enterococci.

The Cephalosporin sub-segment held the second-largest market share. Cephalosporin inhibits cell wall synthesis and is used for treating several multi-drug resistance infections. Cephalosporin mediates its bactericidal effect by binding to the outer membrane of Gram-positive bacteria to inhibit protein, DNA, and RNA synthesis.

Regional Insights

North America region commanded the highest share of more than 42.0% of the antibiotic resistance industry in 2022. The high burden of antibiotic-resistant Gram-negative infections coupled with recent launches to address drug resistance is reinforcing the growth in this region. Moreover, government initiatives and compulsory insurance policies in the region are factors expected to drive the growth in coming years. In the United States, insurance plans cover almost 85.0% of antibiotics to treat infections. Moreover, a strong government strategy for combating antibiotic-resistant bacteria (CARB) developed under the U.S. national action plan incentivizes innovative antibiotic development. Generating antibiotic incentives is the provision of the Food and Drug Administration Safety and Innovation Act.

Asia Pacific region is anticipated to grow at the fastest rate from 2022 to 2030. Unregulated sales and excessive consumption of antibiotics is the key driving factor supporting market growth in developing nations like India and China. Asia Pacific region is the largest antibiotic drug consumer worldwide which increases the risk of developing antibiotic resistance diseases. Hence, the high consumption of antibiotics and lack of effective antibiotic stewardship measures continues to fuel drug-resistant infections in the region.

Key Companies & Market Share Insights

Some of the key players that dominated the global market in 2022 include Merck & Co., Inc.; Allergan plc (AbbVie); and Pfizer Inc. Small or medium-sized biotech manufacturers are largely involved in the development of novel therapies, and these companies market products that specifically target bacterial resistance mechanisms. For instance, in January 2023, Alkem Laboratories launched an antibiotic, Zidavi, for multiple drug-resistant (MDR) infections.

The drug is a combination of avibactam and ceftazidime and is used in the treatment of various infections such as complicated urinary tract infections (cUTI). Zidavi is also approved by the U.S. FDA, EMEA, and CDSCO for complicated intra-abdominal infections (IAIs) & hospital-acquired pneumonia (HAP) as an alternative to colistin and meropenem. Some prominent players in the market include:

• Melinta Therapeutics

• Basilea Pharmaceutica Ltd.

• Tetraphase Pharmaceuticals

• Theravance Biopharma

• WOCKHARDT

• Paratek Pharmaceuticals, Inc.

• Seres Therapeutics

• ACHAOGEN, INC.

• Entasis therapeutics

• AbbVie

• Merck & Co. Inc.

Antibiotic Resistance Market Report Scope

Global Antibiotic Resistance Market Report Segmentation

This report forecasts revenue growth and provides an analysis of the latest trends in each of the sub-segments from 2018 to 2030. For the purpose of this report, Grand View Research has segmented the market report based on disease, pathogen, drug class, mechanism of action, distribution channel and region:

• Disease Outlook (Revenue, USD Million, 2018 - 2030)

  • cUTI (Complicated Urinary Tract Infections)

  • CDI (Clostridioides difficile Infection)

  • ABSSSI (Acute bacterial skin and skin structure infections)

  • HABP (Hospital-acquired bacterial pneumonia)

  • CABP (Community-acquired pneumonia)

  • cIAI (Complicated intra-abdominal infection)

  • BSI (Bloodstream infection)

• Pathogen Outlook (Revenue, USD Million, 2018 - 2030)

  • E. coli

  • K. pneumoniae

  • P. aeruginosa

  • S. aureus

  • A. baumannii

  • S. pneumoniae

  • H. influenzae

  • C. difficile

  • E. faecium

• Drug Class Outlook (Revenue, USD Million, 2018 - 2030)

  • Oxazolidinones

  • Lipoglycopeptides

  • Tetracyclines

  • Combination therapies

  • Cephalosporins

  • Others

• Mechanism of Action Outlook (Revenue, USD Million, 2018 - 2030)

  • Protein Synthesis Inhibitors

  • Cell Wall Synthesis Inhibitors

  • RNA Synthesis Inhibitors

  • DNA Synthesis Inhibitors

  • Others

• Distribution Channel Outlook (Revenue, USD Million, 2018 - 2030)

  • Hospital Pharmacies

  • Retail Pharmacies

  • Online Pharmacies

• Regional Outlook (Revenue, USD Million, 2018 - 2030)

  • North America

    • The U.S.

    • Canada

  • Europe

    • UK

    • Germany

    • France

    • Italy

    • Spain

    • Denmark

    • Sweden

    • Norway

  • Asia Pacific

    • Japan

    • China

    • India

    • South Korea

    • Australia

    • Thailand

  • Latin America

    • Brazil

    • Mexico

    • Argentina

  • Middle East & Africa

    • South Africa

    • UAE

    • Saudi Arabia

    • Kuwait