Washington D.C. - Despite the threat of a global health crisis in antibiotic resistance, worldwide use of antibiotics in humans soared 39 percent between 2000 and 2015, fueled by dramatic increases in low-income and middle-income countries (LMICs), according to a new study in the Proceedings of the National Academy of Sciences (PNAS) . The study, which analyzed human antibiotic consumption in 76 countries, is the most comprehensive assessment of global trends to date.
Researchers from the Center for Disease Dynamics, Economics & Policy (CDDEP), Princeton University, ETH Zurich and the University of Antwerp conducted the study, which found that antibiotic consumption rates increased worldwide from 11.3 to 15.7 defined daily doses (DDDs) per 1,000 inhabitants per day between 2000 and 2015. DDDs are a statistical and standardized measure of drug consumption and represent the assumed average maintenance dose per day for a drug used for its main indication in adults.
Antibiotic resistance is a global health problem; when it emerges in one place, it quickly spreads to other parts of the world. The study underscores the need for consistent global surveillance of antibiotic resistance and policies to curtail unnecessary antibiotic use.
Loss of effective antibiotics is driven in large part by antibiotic consumption, most of which is inappropriate and does nothing to improve health. However, while reducing antibiotic use is critical, increasing access to antibiotics in lower-income countries is also necessary, as these countries suffer from the highest rates of illness and death caused by infectious disease, the study researchers pointed out.
"Finding workable solutions is essential, and we now have key data needed to inform those solutions," said CDDEP researcher and study co-author Eili Klein. "Now, more than ever, we need effective interventions, including stewardship, public education, and curbing overuse of last-resort antibiotics."
Major findings from the PNAS study are as follows:
Despite the rising rates of antibiotic use worldwide, the results suggest that reducing antibiotic consumption is possible. Consumption in high-income countries actually fell slightly over the study period. In addition, the considerable variation in per capita use across high-income countries suggests that there are lessons to be learned.
CDDEP Director and study co-author Ramanan Laxminarayan noted that more than a year has passed since the United Nations General Assembly recognized the global threat of antibiotic resistance, yet little action has been taken since then.
"We must act decisively and we must act now, in a comprehensive manner, to preserve antibiotic effectiveness," Laxminarayan said. "That includes solutions that reduce consumption, such as vaccines or infrastructure improvements, particularly in low-income and middle-income countries. New drugs can do little to solve the resistance problem if these drugs are then used inappropriately, once they are introduced."
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About the Center for Disease Dynamics, Economics & Policy
The Center for Disease Dynamics, Economics & Policy (CDDEP) produces independent, multidisciplinary research to advance the health and wellbeing of human populations around the world. CDDEP projects are global in scope, spanning Africa, Asia, and North America and include scientific studies and policy engagement. The CDDEP team is experienced in addressing country-specific and regional issues, as well as the local and global aspects of global challenges, such as antibiotic resistance and pandemic influenza. CDDEP research is notable for innovative approaches to design and analysis, which are shared widely through publications, presentations and web-based programs. CDDEP has offices in Washington, D.C. and New Delhi and relies on a distinguished team of scientists, public health experts and economists.
Proceedings of the National Academy of Sciences