Decline in Antimicrobial Consumption and Stagnation in Reducing Disease Burden due to Antimicrobial Resistance in...

Area of Science:

• Public Health
• Infectious Diseases
• Pharmacology

Background:

• Antimicrobial resistance (AMR) poses a significant global health challenge.
• Despite reduced antimicrobial consumption (AMC) in Japan post-AMR Action Plan, AMR disease burden has not decreased.
• This study investigates the relationship between AMC and AMR-related disease burden in Japan.

Purpose of the Study:

• To examine the correlation between antimicrobial consumption and the disease burden attributed to antimicrobial resistance in Japan.
• To assess trends in antimicrobial use and AMR-associated disability-adjusted life years (DALYs) from 2015 to 2021.

Main Methods:

• Population-standardized antimicrobial consumption (AMC) was calculated using defined daily doses (DDDs) per 1000 inhabitants per day (DIDs).
• Disease burden due to bloodstream infections from nine major antimicrobial-resistant bacteria (AMR-BSIs) was measured using disability-adjusted life years (DALYs).
• Spearman's rank correlation and cross-correlation functions were used to analyze the relationship between AMC and DALYs.

Main Results:

• Antimicrobial consumption, particularly of third-generation cephalosporins, fluoroquinolones, and macrolides, decreased significantly (40-45%) from 2015 to 2021.
• Conversely, the disease burden (DALYs) due to AMR-BSIs increased from 164.7 to 195.2 per 100,000 population.
• No significant correlation was found between changes in AMC and DALYs, with Spearman's coefficients ranging from -0.37 to -0.50.

Conclusions:

• Reduced antimicrobial consumption in Japan was not associated with a decrease in the disease burden of AMR-BSIs.
• Current AMR countermeasures may require augmentation beyond solely focusing on reducing AMC.
• Additional strategies are necessary to effectively mitigate the health impact of antimicrobial resistance.