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Global antibiotic consumption and usage in humans, 2000-18: a spatial modelling study.

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Global antibiotic consumption increased by 46% from 2000 to 2018, with significant regional disparities. This study provides crucial data for monitoring antibiotic use and combating antimicrobial resistance (AMR).

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Area of Science:

  • Global Health
  • Epidemiology
  • Pharmacovigilance

Background:

  • Antimicrobial resistance (AMR) poses a significant threat to global public health.
  • The World Health Organization (WHO) recommends monitoring antibiotic consumption to combat AMR.
  • Many low- and middle-income countries (LMICs) lack adequate surveillance capacity for antibiotic use.

Purpose of the Study:

  • To estimate global antibiotic consumption using multiple data sources and statistical models.
  • To identify variations in antibiotic usage across different countries and regions.
  • To provide a benchmark for future interventions aimed at optimizing antibiotic use.

Main Methods:

  • Utilized individual-level data from household surveys to inform a Bayesian geostatistical model.
  • Incorporated antibiotic consumption data from IQVIA, WHO, and ESAC-Net.
  • Developed a model for total antibiotic consumption in LMICs and combined it with a model for high-income countries, covering 204 countries over 19 years.

Main Results:

  • Estimated global antibiotic consumption rate of 14.3 DDD per 1000 population per day in 2018, a 46% increase since 2000.
  • Identified significant national and subnational variations in antibiotic usage, with lowest levels in sub-Saharan Africa and highest in Eastern Europe and Central Asia.
  • Observed large spatial disparities, with consumption rates ranging from 5.0 DDD in the Philippines to 45.9 DDD in Greece per 1000 population per day in 2018.

Conclusions:

  • This study is the first to use geostatistical modeling to estimate antibiotic consumption globally from 2000-2018.
  • The findings highlight both high rates of antibiotic consumption and challenges in access to antibiotics in various regions.
  • The data provide a critical benchmark for developing targeted interventions to address AMR and improve antibiotic stewardship.