Global antibiotic use will increase by more than 50% by 2030

Since the pandemic, there has been an increase in antibiotic consumption, especially in middle-income countries, raising concerns about antimicrobial resistance and global health challenges.

Key findings of the study:

The study, published in The Proceedings of the National Academy of Sciences, analyzes antibiotic consumption trends from 2016 to 2023, the impact of the COVID-19 pandemic, economic growth, and forecasts future use to inform policy to combat antibiotic resistance.

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Background

Antimicrobial resistance is a major global problem, causing nearly 5 million deaths in 2019, with the highest mortality rates in low-income countries despite lower antibiotic consumption.

• Resistance arises from the overuse of antibiotics in human, agricultural and veterinary medicine, as well as from poor infection control.
• From 2000 to 2015, antibiotic consumption increased by 65%, driven mainly by low- and middle-income countries (LMICs), while high-income countries (HICs) remain the leaders in per capita consumption.
• Improved surveillance of antibiotic use and its relationship with resistance are needed to develop effective policies.

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About the progress of the research

• The analysis is based on data from 67 countries obtained using the IQVIA MIDAS database of drug sales data.
• Antibiotics were measured in kilograms of active substances and converted into defined daily doses (DDD) according to the WHO classification.
• World Bank data were used to calculate consumption per 1,000 inhabitants per day, with countries divided into income groups: LMICs, UMICs (upper middle income countries) and HICs.

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Research results

1. Increased consumption of antibiotics

• From 2016 to 2023, total antibiotic consumption in 67 countries increased by 16.3%, reaching 34.3 billion DDD.
• Average consumption increased by 10.6%, from 13.7 to 15.2 DDD per 1,000 people per day.
• In LMICs and UMICs, consumption increased by 18.6%, while in HICs it decreased by 4.9%.

2. Impact of the COVID-19 pandemic

• In 2020, due to the pandemic, there was a sharp decline in antibiotic consumption, especially in HICs (-17.8%), but in LMICs and UMICs it quickly recovered after the pandemic.
• The largest increases in antibiotic consumption were recorded in countries such as Vietnam, Thailand, Argentina and India.

3. Changes in consumption structure

• The most widely consumed drugs remained broad-spectrum penicillins, cephalosporins and macrolides.
• In MICs (including LMICs), there has been a significant increase in the consumption of macrolides and fluoroquinolones, as well as "last resort" antibiotics (eg, carbapenems and oxazolidinones).

4. Imbalance in the use of Access and Watch antibiotics

• Access antibiotics are used more in HICs, while Watch antibiotics predominate in LMICs, indicating deficiencies in stewardship of their use.

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Forecasts

• As of 2023, global antibiotic consumption was 49.3 billion DDD, an increase of 20.9% since 2016.
• Without policy changes, consumption could increase by 52.3% by 2030, reaching 75.1 billion DDD.

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Conclusions

• The increase in antibiotic consumption has slowed compared to the period 2008–2015, but remains significant.
• High-income countries are seeing a decline due to improved public health, while middle-income countries are seeing rapid post-pandemic growth.
• Strengthened regulation, equal access to antibiotics and investment in preventive measures such as vaccination, improved sanitation and diagnostics are needed.
• Global initiatives such as WHO's AWaRe are key to combating antimicrobial resistance.