Global increase and geographic convergence in antibiotic consumption between 2000 and 2015.
Eili Y. Klein,Eili Y. Klein,Thomas P. Van Boeckel,Elena Martinez,Suraj Pant,Sumanth Gandra,Simon A. Levin,Herman Goossens,Ramanan Laxminarayan,Ramanan Laxminarayan,Ramanan Laxminarayan +10 more
TLDR
It is found that the antibiotic consumption rate in low- and middle- income countries (LMICs) has been converging to (and in some countries surpassing) levels typically observed in high-income countries, and projected total global antibiotic consumption through 2030 was up to 200% higher than the 42 billion DDDs estimated in 2015.Abstract:
Tracking antibiotic consumption patterns over time and across countries could inform policies to optimize antibiotic prescribing and minimize antibiotic resistance, such as setting and enforcing per capita consumption targets or aiding investments in alternatives to antibiotics. In this study, we analyzed the trends and drivers of antibiotic consumption from 2000 to 2015 in 76 countries and projected total global antibiotic consumption through 2030. Between 2000 and 2015, antibiotic consumption, expressed in defined daily doses (DDD), increased 65% (21.1–34.8 billion DDDs), and the antibiotic consumption rate increased 39% (11.3–15.7 DDDs per 1,000 inhabitants per day). The increase was driven by low- and middle-income countries (LMICs), where rising consumption was correlated with gross domestic product per capita (GDPPC) growth (P = 0.004). In high-income countries (HICs), although overall consumption increased modestly, DDDs per 1,000 inhabitants per day fell 4%, and there was no correlation with GDPPC. Of particular concern was the rapid increase in the use of last-resort compounds, both in HICs and LMICs, such as glycylcyclines, oxazolidinones, carbapenems, and polymyxins. Projections of global antibiotic consumption in 2030, assuming no policy changes, were up to 200% higher than the 42 billion DDDs estimated in 2015. Although antibiotic consumption rates in most LMICs remain lower than in HICs despite higher bacterial disease burden, consumption in LMICs is rapidly converging to rates similar to HICs. Reducing global consumption is critical for reducing the threat of antibiotic resistance, but reduction efforts must balance access limitations in LMICs and take account of local and global resistance patterns.read more
Citations
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Journal ArticleDOI
Differential Drivers of Antimicrobial Resistance across the World
TL;DR: How the global perpetuation of resistance is dictated by highly interconnected socioeconomic risk factors is discussed and it is illustrated that development status should be more fully considered when developing global strategies to address AMR.
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Antibiotic use and the development of inflammatory bowel disease: a national case-control study in Sweden
Long H. Nguyen,Anne K. Örtqvist,Yin Cao,Tracey G. Simon,Bjorn Roelstraete,Mingyang Song,Amit Joshi,Kyle Staller,Andrew T. Chan,Hamed Khalili,Ola Olén,Jonas F. Ludvigsson +11 more
TL;DR: The need to further emphasise antibiotic stewardship to prevent the rise in dysbiosis-related chronic diseases, including IBD is suggested, if substantiated by longer-term prospective studies in humans or mechanistic preclinical investigations.
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Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future
Brian Godman,Mainul Haque,Judy McKimm,Muhamad Abu Bakar,Jacqueline Sneddon,Janney Wale,Stephen Campbell,Antony P. Martin,Iris Hoxha,Vafa Abilova,Bene D. Anand Paramadhas,Pinkie Mpinda-Joseph,Matshediso Matome,Lívia Lovato Pires de Lemos,Israel Abebrese Sefah,Amanj Kurdi,Sylvia Opanga,Arianit Jakupi,Zikria Saleem,Mohamed Azmi Hassali,Dan Kibuule,Joseph O Fadare,Tomasz Bochenek,Celia C. Rothe,Jurij Fürst,Vanda Marković-Peković,Ljubica Bojanić,Natalie Schellack,Johanna C Meyer,Zinhle Matsebula,Thuy Nguyen Thi Phuong,Binh Nguyen Thanh,Saira Jan,Aubrey Chichonyi Kalungia,Sekesai Mtapuri-Zinyowera,Massimo Sartelli,Ruaraidh Hill +36 more
TL;DR: There is a need to document current practices and successful initiatives in LMICs to improve future antimicrobial use, and initiatives to reduce inappropriate prescribing and dispensing of antimicrobials for URTIs as part of NAPs and other activities, are monitored.
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A survey of sub-inhibitory concentrations of antibiotics in the environment.
TL;DR: The findings indicate that environmental concentrations of antibiotics are likely to be influencing microbial ecology, and to be driving the selection of antibiotic resistant bacteria.
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Emerging contaminants in a river receiving untreated wastewater from an Indian urban centre.
TL;DR: A longitudinal survey of the Ahar River for a number of emerging organic contaminants found the concentrations of many of the contaminants within the river water were similar to those commonly reported in untreated wastewater in high income countries.
References
More filters
Journal ArticleDOI
Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: A microbiological and molecular biological study
Yiyun Liu,Yang Wang,Timothy R. Walsh,Ling-Xian Yi,Rong Zhang,James Spencer,Yohei Doi,Guo-Bao Tian,Baolei Dong,Xianhui Huang,Lin-Feng Yu,Danxia Gu,Hongwei Ren,Xiaojie Chen,Luchao Lv,Dandan He,Hongwei Zhou,Zi-sen Liang,Jian-Hua Liu,Jianzhong Shen +19 more
TL;DR: The emergence of MCR-1 heralds the breach of the last group of antibiotics, polymyxins, by plasmid-mediated resistance, in Enterobacteriaceae and emphasise the urgent need for coordinated global action in the fight against pan-drug-resistant Gram-negative bacteria.
Journal ArticleDOI
Extended-spectrum beta-lactamases: a clinical update.
TL;DR: Extended-spectrum β-lactamases represent an impressive example of the ability of gram-negative bacteria to develop new antibiotic resistance mechanisms in the face of the introduction of new antimicrobial agents.
Journal ArticleDOI
Antibiotic resistance—the need for global solutions
Ramanan Laxminarayan,Ramanan Laxminarayan,Ramanan Laxminarayan,Adriano Duse,Chand Wattal,Anita K. M. Zaidi,Heiman F. L. Wertheim,Nithima Sumpradit,Erika Vlieghe,Gabriel Levy Hara,Ian M. Gould,Herman Goossens,Christina Greko,Anthony D. So,Maryam Bigdeli,Goeran Tomson,Will Woodhouse,Eva Ombaka,Arturo Quizhpe Peralta,Farah Naz Qamar,Fatima Mir,Sam Kariuki,Zulfigar A. Bhutta,Anthony R.M. Coates,Richard Bergstrom,Gerard D. Wright,Eric D. Brown,Otto Cars +27 more
TL;DR: The global situation of antibiotic resistance, its major causes and consequences, and key areas in which action is urgently needed are described and identified.
Journal ArticleDOI
Outpatient antibiotic use in Europe and association with resistance: a cross-national database study
TL;DR: Outpatient antibiotic use in 26 countries in Europe between Jan 1, 1997, and Dec 31, 2002 was investigated by calculating the number of defined daily doses (DDD) per 1000 inhabitants per day according to WHO anatomic therapeutic chemical classification and DDD measurement methodology, and the ecological association between antibiotic use and antibiotic resistance rates was assessed using Spearman's correlation coefficients.
Journal ArticleDOI
Tipping elements in the Earth's climate system
Timothy M. Lenton,Hermann Held,Elmar Kriegler,Elmar Kriegler,Jim W. Hall,Wolfgang Lucht,Stefan Rahmstorf,Hans Joachim Schellnhuber,Hans Joachim Schellnhuber +8 more
TL;DR: It is explained how, in principle, early warning systems could be established to detect the proximity of some tipping points, and critically evaluate potential policy-relevant tipping elements in the climate system under anthropogenic forcing.
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